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Biologic Response Modifiers
A newer group of medicines are now available to treat moderate to severe psoriasis. This group of drugs are called biologic response modifiers, or biologics for short. They are made from proteins produced by living cells instead of chemicals. They interfere with specific immune system processes that cause the overproduction of skin cells and inflammation. Some examples are:
- Alafacept (Amevive®)
- Etanercept (Enbrel®)
- Infliximab (Remicade®)
- Adalimumab (Humira®)
- Ustekinumab (StelaraTM).
These medicines are given by injection. Alafacept, etanercept, adalimumab, and ustekinumab are injected into the skin or muscle by the patient, a family member or nurse. Infliximab is injected into a vein by a healthcare provider. It takes about two to three hours.
People taking these psoriasis treatments need to be monitored carefully by their healthcare provider. Since these medications suppress the immune system response, people taking these drugs have an increased risk of infection, and the drugs may also interfere with vaccines. That is why they should not be used in people with serious infections, such as tuberculosis.
Also, some of these drugs have been associated with other diseases, like central nervous system disorders, blood diseases, cancer, and lymphoma, although their role in the development of or contribution to these diseases is not yet understood. Some are approved for adults only, and their effects on pregnant or nursing women are unknown.
These medications are not indicated in routine psoriasis treatment. However, antibiotics may be employed when an infection, such as that caused by the bacteria Streptococcus, triggers an outbreak of psoriasis, as in certain cases of guttate psoriasis.