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Biologic Treatments for Psoriasis: A Comprehensive Guide

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oceanskin2025
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Psoriasis is a chronic autoimmune condition that affects millions of people worldwide, including a significant number of patients in India. While traditional treatments such as topical steroids, phototherapy, and systemic medications are effective for some, many individuals with moderate to severe psoriasis require advanced therapies. Biologics have emerged as a revolutionary treatment option, offering targeted relief by addressing the underlying immune dysfunction. This blog post provides a detailed overview of the biologic treatments available for psoriasis.

What Are Biologics?

Biologics are advanced drugs derived from living cells that specifically target certain components of the immune system responsible for psoriasis. Unlike conventional systemic treatments, which broadly suppress the immune system, biologics work by inhibiting key inflammatory pathways involved in the disease process.

Biologics used for psoriasis primarily target:

  • Tumor Necrosis Factor-alpha (TNF-α)
  • Interleukin-12 and Interleukin-23 (IL-12/23)
  • Interleukin-17 (IL-17)
  • Interleukin-23 (IL-23)

Biologics Available for Psoriasis

1. TNF-Alpha Inhibitors

These biologics target TNF-alpha, a key inflammatory cytokine involved in psoriasis.

✅ Adalimumab (Humira, Exemptia, Adfrar)

  • One of the most widely used biologics for psoriasis.
  • Administered as a subcutaneous injection.
  • Available as both originator (Humira) and biosimilars (Exemptia, Adfrar) in India.

✅ Etanercept (Enbrel, Etacept, Intacept)

  • Used for moderate to severe plaque psoriasis.
  • Administered via subcutaneous injection twice weekly.
  • Available in biosimilar forms (Etacept, Intacept) in India.

✅ Infliximab (Remicade, Infimab, Flixabi)

  • Administered via intravenous (IV) infusion.
  • Effective for severe and refractory cases of psoriasis.
  • Biosimilars such as Infimab are available in India.

2. IL-12/23 Inhibitor

These biologics block interleukins 12 and 23, which play a role in immune system dysregulation in psoriasis.

✅ Ustekinumab (Stelara)

  • Administered as a subcutaneous injection.
  • Highly effective for both plaque psoriasis and psoriatic arthritis.
  • Currently available in India but at a higher cost.

3. IL-17 Inhibitors

IL-17 inhibitors target interleukin-17, a key cytokine in the inflammatory process of psoriasis.

✅ Secukinumab (Cosentyx)

  • A widely used IL-17 inhibitor.
  • Administered via subcutaneous injection.
  • Effective for both plaque psoriasis and psoriatic arthritis.

✅ Ixekizumab (Taltz)

  • Another IL-17 inhibitor that provides rapid improvement in psoriasis symptoms.
  • Subcutaneous injection therapy.

✅ Bimekizumab (Not yet widely available in India)

  • A newer IL-17A and IL-17F inhibitor with promising results.

4. IL-23 Inhibitors

IL-23 inhibitors specifically target interleukin-23, which plays a critical role in the development of psoriasis.

✅ Guselkumab (Tremfya)

  • One of the advanced biologics for psoriasis treatment.
  • Provides long-term skin clearance with a favorable safety profile.

✅ Risankizumab (Skyrizi)

  • Offers high efficacy and durability in psoriasis treatment.
  • Administered as a subcutaneous injection.

✅ Tildrakizumab (Ilumya)

  • Approved in India for moderate to severe plaque psoriasis.
  • Administered every 12 weeks after initial doses.

Who Can Benefit from Biologic Therapy?

Biologics are typically recommended for:

  • Patients with moderate to severe psoriasis who do not respond to conventional treatments.
  • Individuals with significant impairment in quality of life due to psoriasis.
  • Patients with psoriatic arthritis requiring systemic treatment.
  • Those who cannot tolerate other systemic medications like methotrexate or cyclosporine.

Considerations Before Starting Biologics

Before starting biologic therapy, patients should undergo: ✅ Screening for tuberculosis and hepatitis.
✅ A complete blood count and liver function tests.
✅ Vaccinations if needed (e.g., flu, pneumococcal, hepatitis B).
✅ Regular follow-ups to monitor response and side effects.

Cost and Accessibility of Biologics in India

While biologics offer significant benefits, they are expensive compared to traditional therapies. However, the availability of biosimilars has helped reduce costs, making these treatments more accessible. Many pharmaceutical companies in India offer assistance programs to help patients afford biologic therapy.

Conclusion

Biologics have transformed the management of psoriasis by providing long-term disease control with minimal side effects. In India, a range of biologics, including TNF-alpha inhibitors, IL-12/23 inhibitors, IL-17 inhibitors, and IL-23 inhibitors, are available for patients with moderate to severe psoriasis. With increasing awareness and affordability, more patients can access these life-changing treatments under the guidance of experienced dermatologists.

If you’re struggling with psoriasis and considering biologic therapy, consult a dermatologist to find the best treatment option tailored to your needs.

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