At some point in yourpsoriasis treatment journey, you may be at a crossroads.
Your doctor may also suggest a biologic if youve had too many side effects from other medications.
Why are you recommending a biologic?
It’s normal to have a number of questions about starting biologics.
Okay, so youre sitting in the office, listening to your doctor talk about biologics.
Butwhyare they suggesting this now?
It likely has something to do with the severity of your symptoms.
I was so covered inpsoriasisthat I was wearing long sleeves and jeans in 90-degree heat, he says.
Other treatments can also be challenging to keep up with long-term.
Which biologic do you think is best for me and why?
There are currently more than a dozen different biologic drugs that treat psoriasis.
Each one blocks a specific part of the immune response that triggers psoriasis flares.
Thats great because you have a lot of options, but it can also feel a little daunting.
Here is where the trial-and-error part comes in, as everyone responds differently to these medications.
Your personal preference is also important.
Are there potential side effects I should expect from biologics?
He says the vast majority of his psoriasis patients have no problems when taking these medicines.
But side effects can happen, so its important to have this discussion with your doctor.
One of the most common is a skin reaction like localized inflammation or bruising at the injection site.
Shed already seen that happen to her son, who also has psoriasis.
He would get infections pretty easily and he would have a more difficult time overcoming them.
I was wondering if my outcome would be similar to his, she says.
Thats because biologics dial down the immune system, meaning an increased chance of infection is a real risk.
Are biologics safe if I want to have a baby?
This is a gray area.
There are some biologics that can cross the placental barrier and potentially reach the fetus.
The possibility of birth defects is unknown in many cases.
How do I take a biologic drug?
Biologics are injected into the body as a shot or an infusion into a vein.
Before cursing science for not coming up with a pill form yet, hear us out.
They have to be administered that way because theyre made of delicate proteins.
Your answer will depend on several factors, some of which might be logistical.
Others come down to your personal preference.
So, in certain instances, your choice may be made for you.
How much do biologics cost?
Are they covered by insurance?
Because biologics are the new, fancy kid on the block, theyre pretty expensive.
If that doesnt work, its worth looking into a medication assistance program.
Many pharmaceutical companies offer these to help cover the cost of co-pays, which Moy has used successfully.
How long do I need to take a biologic before I see an improvement?
Some biologics, like the IL-17 inhibitors, work very quickly.
But the 12-week mark is when you might expect to see the maximum benefit from most biologics.
How much improvement can I expect?
This is where all that agonizing decision-making can pay off.
Todays biologics work so well that most people see significant improvement or even complete skin clearance.
How will I know if my biologic isnt working?
The effectiveness would just wear off and it was almost like I wasnt taking any medications.
I was flaring constantly and couldnt get the disease under control anymore, she recalls.
Thats when she knew it was time to switch to something else.
(That is, unless you have an allergic reaction to it.
In that case, youll need to ask your doctor about stopping soonerlike, right now.)
If this biologic doesnt work, what do I do next?
If one biologic doesnt work, your doctor can recommend another one.
Now, hes on his fourth biologic, and he fully expects to have to switch again.
We take a stab at see to it there is the least number of stoppages, Dr. Keller says.
