Immune system medications (biologics) for psoriasis

Examples

A shot (injection) or IV (intravenous)

Generic Name	Brand Name
adalimumab	Humira
alefacept	Amevive
efalizumab	Raptiva
etanercept	Enbrel
infliximab	Remicade

Alefacept is taken once a week in an IV (intravenously) or once a week as a shot in a muscle. Dosage depends on your body weight.

Efalizumab and Enbrel are usually taken once a week as a shot under the skin. Some people learn to give themselves the shots at home. Dosage depends on your body weight.

Infliximab is given in three 2-hour IV (intravenous) doses in the doctor's office in the first 6 weeks, then every 4 to 6 weeks.

How It Works

Biologics block harmful responses from the body's immune system that lead to the symptoms of psoriasis.

Why It Is Used

Biologics are used to treat moderate to severe chronic plaque psoriasis and psoriatic arthritis. Alefacept, efalizumab, and etanercept have been recently approved for treatment of psoriasis, and all show promising results. Etanercept, infliximab, and adalimumab have been approved for treating psoriatic arthritis. Infliximab is being tested for use in psoriasis.

How Well It Works

These biologics significantly decrease symptoms of psoriasis, providing rapid and sustained improvement. Continued treatment can lead to extended remission from symptoms.^{1, 2}

Side Effects

Biologics are generally well tolerated in clinical trials. Side effects vary a bit depending on the medicine but can include headache, chills, fever, nausea, muscle pain, and reaction at the injection site that can include pain and itching. Most of these side effects last only a few days.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

The safety of long-term treatment is not known.

These medications probably will have to be taken for long periods of time—possibly even for life.

Biologics do not cause kidney and liver problems, as some other psoriasis treatments can.²

Because biologics interfere with the immune system, there is a possibility that they may raise your risk of infection, anemia, and possibly even cancer. Medicines that suppress the immune system are not usually given to people with impaired immune systems. If you take biologic drugs, you may have tests now and then for tuberculosis.

People infected with human immunodeficiency virus (HIV) should not take alefacept (Amevive). Alefacept can cause HIV to get worse more quickly or increase complications.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

Author:	Shannon Erstad, MBA/MPH Ralph Poore	Last Updated January 6, 2006
Medical Review:	Patrice Burgess, MD - Family Medicine Kathleen Romito, MD - Family Medicine Alexander H. Murray, MD, FRCPC - Dermatology
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