The Marvelous World of Biologics: A Psoriasis Treatment Breakthrough

Could a Biologic Effectively Treat My Psoriasis?

Biologic Psoriasis Savior?

When Howard Chang, 50, first heard about biologic treatments for psoriasis almost 20 years ago, he was itching to give them a shot. Now, they’re an essential part of his overall treatment plan.

Chang’s journey with psoriasis started when he was just 8 years old. He tried every trick in the book—from tar and phototherapy to topical creams and ointments, steroids, and even oral medications. But finding something that actually worked was like a needle in a haystack.

“I was constantly on the lookout for the next big thing because it was so difficult for me to find an effective treatment,” Chang admits.

Enter biologics, the superheroes of the psoriasis world. These drugs, also known as biologic medications, work by tinkering with your immune system. Instead of popping a pill, you usually give yourself a shot—although a few are administered through an IV at your doctor’s office. The FDA approved the first two biologics for psoriasis back in 2003, and we’ve seen an army of options emerge since then.

Generally, biologics are prescribed for people with moderate to severe psoriasis, based on the extent of skin involvement. But doctors also take into account how psoriasis affects a person’s life when making this decision, says the ever-wise Malini Fowler, MD, a board-certified dermatologist in San Antonio, TX.

“There’s no one-size-fits-all candidate,” says Fowler. “Even if someone has mild disease, they might still be a candidate for biologics, depending on how it impacts their life.”

But that’s not all—these biologic wonders don’t just clear up your skin, they might also save the day for your heart, joints, and other body parts plagued by inflammation.

“When we talk about biologics, we’re talking about a systemic medication that works from the inside out, reducing psoriasis on the skin and hopefully tackling inflammation on the inside too,” explains Fowler.

Now, before you decide to dive headfirst into the biologic pool, there are a few things you need to know. Chang did his homework before taking the plunge, reading up on how the drugs work, their potential side effects, and the risks involved.

“Injecting something into your body is a decision that requires serious thought, especially when it affects your immune system,” notes Chang.

And who better to confide in than your friendly neighborhood dermatologist? Chang emphasizes the importance of finding a dermatologist who understands the ins and outs of these medications and collaborates with you as a person. Together, you can create an incredible plan.

But like any true superhero, biologics aren’t without their kryptonite. While they can alleviate psoriasis symptoms, they come with potential dangers, just like any other drug. Some might increase your chances of developing inflammatory bowel disease or cancer.

“Be careful if you already have underlying cholesterol or hypertension issues,” warns Fowler. “Every biologic has a different mechanism of action and safety profile.”

So, make sure to discuss any existing health conditions or medications you’re taking with your doctor. This way, they can ensure the biologic won’t clash with your existing lineup.

For Chang, finding the right biologic has been a journey itself. He has sampled six different biologic drugs since 2003. One provided relief for about 8 years, but he had to switch up the rest due to unpleasant side effects, diminished effectiveness over time, or a lack of results altogether.

“While many people achieve healthier skin with biologics, my treatment hasn’t been as successful,” Chang reveals.

“It’s like I’ve never really been able to pull off clear skin,” he explains. “It’s not a cure. There are still triggers that can cause a flare.”

Finding the perfect biologic for your needs can be emotionally exhausting. Chang likens it to a roller coaster ride, with high hopes for each new drug and the anticipation of its effects. Sometimes, though, it can be a major letdown.

“Especially since psoriasis has such a significant impact on my life. It’s like I can’t fully function because of the physical discomfort I experience when I’m running, working, teaching, or meeting people. I just want to be comfortable,” Chang sighs.

But don’t lose hope, true believers! Fowler recommends giving a biologic at least three months to work its magic.

“Not every medicine is a match for every person, but it’s important to stick with the medications and give them a fair chance,” she advises. “I tell my patients, ‘If this doesn’t work, we’ll move on to the next one. We’ll find the perfect medicine for you, but it might involve a bit of trial and error.’”

While biologics are the star of the show, Chang continues using other psoriasis treatments like topical creams and phototherapy.

“With biologics, I feel a sense of relief. I no longer have to be perfect with every other aspect of my treatment,” he says. “It’s comforting to know that there’s a medication working quietly in the background.”

And let’s not forget the importance of stress management, exercise, and healthy eating for keeping flare-ups at bay. These habits can also save the day when it comes to metabolic syndrome—a cluster of conditions that increase the risk of stroke, type 2 diabetes, and heart disease. People with psoriasis are more prone to developing metabolic syndrome.

In addition to regular visits to the dermatologist while on biologics, Fowler suggests keeping your primary care doctor in the loop, getting an annual blood work-up, and seeing a rheumatologist every six months. After all, around 30% of people with psoriasis will develop psoriatic arthritis, so it’s best to stay vigilant.

Now, let’s tackle one of the biggest challenges of taking biologics—learning to inject the medications yourself. Chang has become somewhat of a pro, having self-administered over a thousand injections.

Fortunately, newer biologics have significantly reduced the number of injections needed. Chang used to have to give himself shots twice a week, but now they can be weeks or even months apart, depending on the medication.

To ease the process, Chang has developed a routine. He meticulously washes his hands, gathers all the necessary materials, and sets the perfect stage by preparing something to watch in the background.

“A routine allows me to stay calm,” Chang says. “Self-injection is something you never truly get used to, but you do get better with practice.”

One last challenge—getting approval from your insurance company to cover different biologics. But fear not, as Chang remains optimistic that treatments for psoriasis and other options will continue to improve.

“It’s a time of great hope for those living with psoriasis,” Chang concludes. “With all the research, medication advancements, and advocacy, we have choices now and even more on the horizon.”

So, fellow psoriasis warriors, don’t let anything stop you from exploring the possibilities offered by biologics. Embrace the adventure, find your perfect match, and say goodbye to stubborn plaques. Your skin—and your superhero self—deserve the relief they bring.

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