Conventional treatment for psoriasis also includes the area of biologic therapies also known as biologics for psoriasis as well as psoriatic arthritis treatment and new developments in this area are ongoing. This therapy uses highly targeted medications known as “biologic agents” to interfere with the process that leads to the development of psoriasis lesions. There are many types of medications that are used for biologic therapies including adalimumab (Humira®). This article looks into how Humira® for psoriasis works.
The 411 on Biologics
While psoriasis is still not fully understood, it is believed that it is an autoimmune condition which means that the immune system attacks healthy cells by sending faulty messages to various areas of the body. In the case of psoriasis, the immune system due to imbalances in the immune system sends these faulty messages to the skin cells leading to the rapid cell turnover that causes scaly, raised, red patches of skin as well as other signs and symptoms of psoriasis.
The use of biologic therapies is thought to be more effective than other conventional treatment options such as systemic therapies because the biologic medications target these abnormalities in the immune system to prevent the immune system from sending faulty messages to skin cells.
Unlike other medications which are made from chemicals, biologics are created using living cells including animal cells, human cells, viruses, etc, and have natural counterparts including proteins, enzymes, etc.
These drugs are usually expensive ranging from $15,000 to $25,000 because they are difficult to make in order for them to successfully target certain abnormal aspects of the immune system. Biologics are usually injected under the skin or muscle or administered intravenously. This is because if they are taken orally, they will simply be broken down in the digestive tract since they are usually protein based and will not reach the immune system to do the work they were created for.
The medications used as mentioned previously are considered more effective and come with less side effects than many of the medications used in systemic therapies such as various steroids and vitamin A derivatives but the long term effects of biologic drugs are still being studied as many of the drugs used were only approved for psoriasis and psoriatic arthritis in the last decade or so.
There are many different types of biologic drugs used and many of them work differently in terms of components, effects, side effects, etc. One of these biologic drugs used is adalimumab (Humira®).
Humira® for Psoriasis
Humira® or adalimumab is used for the treatment of psoriasis, rheumatoid arthritis as well as psoriatic psoriasis.
This biologic drug and others of this type work by binding and blocking the tumor necrosis factor alpha (TNFα) which is an important part of the immune system. Interfering with its activities can help with psoriasis as well as psoriatic arthritis. TNFα is a chemical made by the immune system cells that sends faulty messages to skin cells as well as the joints.
TNFα is produced much more by psoriasis and psoriatic psoriasis sufferers which then causes inflammation that leads to the various symptoms of psoriasis and psoriatic arthritis.
Humira® for psoriasis works by blocking as well as reducing the amounts of TNFα which then reduces inflammation which helps prevent psoriasis lesions as well as tender joints.
When using Humira® for psoriasis, the effects are usually noticed within the first month of use although it may take a few months to notice a positive change in some cases.
A self-administered injection is usually used under the skin and contains about 80 milligrams the first day which is then reduced to 40mgs every other week or as recommended by your doctor. All step by step instructions on how to self-administer the injection will be given to the psoriasis sufferer by your doctor.
Before starting adalimumab, a test to determine whether you have been exposed to tuberculosis (TB) will be required. Other concerns besides TB before starting this treatment that you need to discuss with your doctor include;
- Pregnancy (current or planned)
- Whether you are breast feeding
- History of cancer or heart disease
- Whether you have a compromised immune system from some disease such as HIV/AIDS
- Infection issues
- Whether you are on other medications or supplements
- Any allergies
Caution with Use of Adalimumab
When using biologic therapies as well as other medications that target the immune system by suppressing it to some extent, there is always a risk of developing new infections. If you develop an infection after starting this treatment, contact your doctor as you may need to stop administering this medication.
If you develop fatigue, fever, cough, etc, these are some symptoms of an infection to watch out for and since adalimumab is an immunosuppressant, your immune system may be unable to respond effectively to these infections. If a serious infection develops, stop use of adalimumab.
Other issues that may develop due to a suppressed immune system from using adalimumab include symptoms of heart failure or cancer development. If these symptoms develop, inform your doctor immediately.
When using adalimumab, you may develop flu-like symptoms or a cold. You may also develop headaches, redness at the infection site and/or swelling, etc.
Using Humira® for psoriasis or other biologic therapies is something to discuss with your doctor as you may be able to get relief from the various symptoms of psoriasis. Though it is very expensive, your insurance may be able to cover all or most of the cost although due to the expense, your insurance company may first want you to try other less expensive therapies before opting for biologic therapies.