My One Year Biologic Anniversary

The 12th of February marks a special anniversary for me. It marked one since I started my biologic injection. This particular injection was what cleared my psoriasis completely.

When does a biologic treatment become available for psoriasis?

There are many treatment options for psoriasis. In the UK, generally, you’ll start on over-the-counter products that are coal-tar or salicylic acid-based. If these don’t work, you’ll move on to UVB light therapy. If that doesn’t work, you’ll go on to oral products like methotrexate or cyclosporin.

Failing that, you’ll then get the option to try a biologic treatment. Generally, your psoriasis must be moderate to severe in severity for the National Health Service (NHS) to be willing to fund a biologic treatment.

If you’re in the US, it will depend on your insurance policy, the severity of your psoriasis, and your relationship with your healthcare provider.

How do biologics work for psoriasis?

The good thing about biologic treatments is that they don’t target the entire immune system: they just target the specific areas that are overactive. They work by blocking an immune system cell called the T-cell or by blocking specific proteins in the immune system.

These include interleukin 12 or interleukin 23. My biologic, Cosentyx, works by blocking a protein called interleukin 17. You take the biologic either by injection or an infusion, depending on which biologic treatment you want.

I started with Stelara, which is an injection treatment, but came off that after six months because it wasn’t working as effectively as it should be.

What are the risks for biologic treatments?

Your healthcare team should warn you of the risks of taking a biologic. Common side effects include cold sores, diarrhea, and a runny nose. These can be burdensome but you have to weigh up: do you want psoriasis or do you mind having a bit of a blocked nose for a few days? I’ve been lucky with Cosentyx.

When I was on Stelara, I often had cold sores which would take a while to clear-up and it disrupted my social and job life. But, since moving to Cosentyx, I’ve only had a few minor side effects. The worst I’ve had is a fungal infection in the armpits.

Luckily, my dermatologist recommended having an anti-fungal infection tube of cream which has helped to clear the infection and keep it away. I know, however, that if it comes back or appears elsewhere on the body, that I can just apply the cream again and it should clear it up.

There are some more serious side effects, including the possibility of a severe allergic reaction. But it’s important to point out that these are rare and your healthcare team will advise you as is necessary.

What does taking a biologic look like?

Well, each biologic is different. One you may inject yourself, one will involve a nurse, and others may involve infusions at your doctor’s surgery.

Stelara, the first injection I had, involved a nurse coming to my house every few months to give me the injection. I was unable to do this one myself. The good thing about the latest injection I’ve been on, Cosentyx, is I can administer it myself.

I was worried about injecting myself at first because of the needle, but the more I’ve done it, the more comfortable I’ve felt with it.

The convenience of a biologic

And my healthcare team made sure I had regular blood tests. At the beginning of taking the biologic, I saw my dermatologist every 3 months or so, so any problems in the blood would be detected. I have it less now but each time I see him I still make sure I have a blood test. So far, all has been good and I haven’t had anything to worry about.

The great thing about doing the injection yourself is it’s not disruptive to work or educational schedules. I don’t need to find out when a nurse can come, and since I’ve started, I’ve had my injections delivered to a nearby pharmacy store so I can collect it when it’s convenient for me.

Often with psoriasis, the treatments can either be really messy or really inconvenient; taking up time and marking your clothes, but with a biologic, you don’t have this worry.

Celebrating one year on a biologic

So, how’s my life been since taking the biologic? It’s been wonderful. My psoriasis took about 3 months of starting treatment to clear. Initially, I had to take the biologic every week but after a month’s worth of doing that it moved to monthly.

For the last year, I have been administering my biologic myself. I’ve had no problems with injecting: all I do is follow what the instructions say and where to place the biologic. My psoriasis has completely cleared. I don’t have a patch.

It’s been the most life-changing thing I’ve taken. It’s given me confidence, made me happier, and allowed me to enjoy my life more than I ever have done before.

The importance of remaining positive

But I am wary. I have heard stories from people that the biologic stops working after 18 or 24 months. I am only up to one year. But everyone is different. I am hopeful that the biologic will continue helping me into the future.

I have been on other treatments – such as UVB light therapy – and they stopped working with a terrible rebound effect afterward. But you’ve got to remain positive. I am so thankful for the NHS here in the UK. We don’t have to worry about insurance and it’s helped tremendously.

Don’t give up, keep going, and stay strong

The days are long gone feeling down and depressed. I am up and about and looking forward to what the future holds. If you’re in a rut and don’t know what else to do, I would say keep going. I never thought I’d find anything that would help but I was proved wrong.

And even if it’s the case that the biologic will stop working, there are still many other biologics out there which I haven’t tried, so that keeps me hoping.