What Are Biologics?

Reviewed by: HU Medical Review Board | Last reviewed: December 2023

Biologics are a type of medicine approved to treat conditions like psoriasis. They are some of the most effective treatments for severe psoriasis. Biologics target a specific part of your immune system to help reduce inflammation.1-3

How do biologics work?

Biologics are a type of drug made from parts of living cells. Biologics block the action of pro-inflammatory proteins called cytokines. Cytokines bind to proteins on the surface of cells. This increases immune system activity and inflammation.1,2

Different biologics block different cytokines. Biologics for psoriasis may block:1,2

  • Tumor necrosis factor alpha (TNF-alpha)
  • Interleukin-17 (IL-17)
  • Interleukin-23 (IL-23)
  • Interleukin-12 and 23 (IL-12, IL-23)

Examples of biologics

Many biologics have been approved by the US Food and Drug Administration (FDA) to treat psoriasis. Biologics are categorized by the cytokine they block. The right option for you depends on your symptom severity, personal preference, and other factors.2-4

TNF-alpha blockers include:1,4

IL-17 blockers include:1,4,5

IL-23 blockers include:1,4

IL-12 and IL-23 blockers include:1,4

Enbrel, Stelara, and Cosentyx are approved to treat children with psoriasis.3

Biosimilars are a type of biologic that are similar to a previously approved drug. They have the same active ingredients, benefits, and side effects. Biosimilars approved to treat psoriasis include:6-8

  • Humira biosimilars: Amjevita®, Cyltezo®, Hyrimoz®, and others
  • Remicade biosimilars: Inflectra®, Renflexis™, Avsola®, and Ixifi™
  • Enbrel biosimilars: Erelzi™ and Eticovo™
  • Stelara biosimilar: Wezlana™

Not all of these biosimilars are available at the time of this writing.6

What are the possible side effects?

Biologics can increase the risk of infections. Talk to your doctor about how to reduce your risk. Call your doctor right away if you notice any signs of infection, such as fever, cough, or flu-like symptoms.1,2

Other side effects can vary depending on the specific drug you are taking. Common side effects of biologics include:3

  • Redness or pain at the injection site
  • Rash
  • Diarrhea
  • Headache
  • Swelling of the face, mouth, or throat
  • Urinary tract infections

Serious side effects are possible. Many biologics have boxed warnings, the strictest warning from the FDA. Enbrel, Remicade, Humira, and Cimzia have these warnings because of an increased risk of serious infections and certain cancers. Siliq has this warning because of an increased risk of suicidal thoughts and behavior.9-13

These are not all the possible side effects of biologic drugs. Talk to your doctor about what to expect when taking a biologic. You should also call your doctor if you have any changes that concern you when taking a biologic.

Other things to know

Biologics are given as an intravenous (IV) injection or infusion. You may be able to do some injections at home. Other injections must happen at a doctor’s office or hospital. Your doctor will talk to you about how often to take your biologic.1-3

Many biologics are approved to treat multiple conditions. Some are used to treat other types of psoriasis or psoriatic arthritis. Biologics may be combined with other treatments for psoriasis. They are often used with phototherapy, topicals, or other systemic drugs. Talk to your doctor to make sure your combination is safe.2

Your doctor will monitor you for side effects. This may include screening for tuberculosis and other infections. They will also monitor you to see how well the biologic is working. Biologics may stop working over time. If this happens, your doctor may switch you to a different biologic.2,3

Before beginning treatment for psoriasis, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs. Make sure to tell them about:3

  • Any allergies
  • History of inflammatory bowel disease
  • Past or current infections
  • History of heart or liver problems
  • Pregnancy or plans to become pregnant
  • Breastfeeding or plans to breastfeed

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