Q:
Do these drugs treat psoriatic arthritis?
A:
The TNF inhibitors—Remicade, Humira, and Enbrel—work for psoriatic arthritis.
Q:
Are there any patients who should definitely not take biologics?
A:
Your doctor should determine whether taking a biologic is appropriate. Each of these medications has specific contraindications in their prescribing information. But certainly, if you are being treated for an infection or have signs of an infection, it is better to wait until the infection has cleared before starting treatment. People with diabetes or other immune system problems or people taking another immunosuppressant medication are not good candidates for treatment with a biologic. Since the effects of these drugs on pregnancy haven’t been well studied, they should probably be avoided by pregnant women, except under very special circumstances.
Q:
How do you choose which class to use?
A:
The TNF blockers are often the physician's first thought when it comes to biologics. There are a lot of reasons for this, but the fact that they are quite effective and have a reasonably long safety record is the most likely reason why this class is chosen more often than the others. However, there are times when a T-cell blocker is preferred, like when a person doesn’t respond to a TNF blocker or has a special type of psoriasis, such as psoriasis of the palms and soles of the feet. The IL-12/23 blocking drug is not available to the public yet, but when it is approved by the FDA, it is likely to be an important additional tool to fight psoriasis. Someday in the not too distant future, we will be able to use a blood test to tell which of the available treatments is likely to work best—instead of relying so much on trial and error.
Q:
How have biologics changed the treatment of psoriasis?
A:
The potent effect of the biologic class of medicines has really increased our expectations regarding new treatments. The bar has definitely been raised, and with this in mind, I expect that more effective and convenient treatments will be coming out in the near future.
Psoriasis:Treatment Overview
Health Journey
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