Can Switching Biologics Help Your Psoriasis?

Last month, I wrote about going on to Skyrizi - my third biologic. I said I would report back on whether it has helped.

Prior to starting this treatment, I had been on two previous biologics, which were Stelara and Cosentyx. I had stopped Stelara mainly due to inefficacy. I had stopped Cosentyx due to inefficacy and some associated side effects.

What does research say?

My health team warned me prior to starting Skyrizi that the more you use different biologics, it may not be as effective in treating psoriasis symptoms. And well, the literature on the topic is mixed.

One study I read says switching biologics ‘may improve’ psoriasis, while another says that it may also improve symptoms in those who first time round didn’t respond. ^1,2

Is switching worth it?

Overall, I think if you’re considering switching biologic treatments, then it’s worth it. My treatment journey included two biologics that weren’t sufficiently treating my symptoms, or, in the case of Cosentyx, it worked wonders at first, but then stopped working as the months and injections went by.

I was really disappointed when my treatment stopped working. I had tried lots of conventional treatments prior, including phototherapy, cyclosporine, creams, topical treatments and ointments, and nothing had shifted the problem, but these biologics did.

Finally seeing improvement

I am one month in on my third biologic and I am already seeing results. Patches of psoriasis have started to lessen and new outbreaks are being contained. My PASI score (how they assess the severity of your psoriasis) has remained largely the same, but it’s still early days and I can see some improvement.

My big fear from this treatment is that, like the other two, it becomes inefficient. Biologics are expensive treatments and I have been advised that as long as they are working, I could stay on them. My fear is that if the results are not good enough, I will have to cease treatment. I don’t know if I’m allowed to keep switching, so this is a worry for me.

Biologics with a side order of...

The other worry is the side effects. I had to stop Cosentyx due to inefficacy and some associated side effects. These included infections. It was a very difficult time when I started developing infections in different parts, like around my mouth.

I had to get different treatments because it could have been caused by a number of different issues. I don’t particularly want something like that to happen again. I am not particularly bothered about anything else associated with the biologic. Of course, there are long-term factors to consider, but I am confident in the drug regulatory bodies that approve these medications for use.

Make your healthcare team work for you

I would say to anyone who is considering a biologic to have a good conversation about it with your medical team. Go in armed with information and make sure you have all the questions you want to be answered. These are powerful medications with lots of things to consider.

If you’re already on a biologic and want to switch, then again, discuss this in detail with your healthcare team. I chose Cosentyx as my second medication and it gave me relief for the best part of two years. Skyrizi is doing well at the moment and I’m going to continue monitoring it as the months and days go by.

Good luck with your biologic journey and hopefully you’re going to experience relief soon.