This thread is intended to give you information on the 6 common prescribed biological treatments for psoriasis & psoriatic arthritis. You should always check the information with your GP or Dermatologist.

I will lock this thread to save any confusion, if you want to comment on the thread please start a new topic or send me a PM.

What Are Biologics ?
Biologic drugs are made from living human or animal proteins. They are designed to treat psoriasis and psoriatic arthritis by targeting overactive cells in the body. Some biologics target a type of immune cell called T cells while others target the chemical messengers released by activated T cells.

Tests: Patients should be checked for tuberculosis (TB) before taking Biologicals and you should have regular blood tests. You may also be given X Rays.

Storage:
Always keep Biologicals in the fridge (Not Freezer) Take them out about 15 minutes before using this will make them sting less. Please follow the relevant link to the manufacturers web site for detailed storage instructions.

Using:
Always wash your hands well before use and make sure you have a clean area to work on, wipe the area of skin well with the alcohol swab provided with the medication. Pinch an inch of skin on your chosen site usually the stomach, and stab the needle in "don't push it in" the slower you go the more it will sting. Slowly push the syringe till all the medication has gone, remove the needle, let go of your skin and give a final wipe with an alcohol swab. Don't worry about injecting yourself it's a simple process and not painful, and your adviser will make sure you are comfortable with it before letting you go it alone. But once you do, you will wonder what all the fuss is about.
For detailed instructions please follow the relevant link to the manufacturers web site found in each post.

Side Affects: Please read each section for side affects and follow the link to the manufacturers web site.

There are 8 common prescribed Biological treatments. Please click a biologic from the list or scroll down to view all.

Adalimumab - Humira Targets TNF-a

Etanercept - Enbrel Targets TNF-a

Infliximab - Remicade Targets TNF-a

Ustekinumab – Stelara Targets interleukin 12 and interleukin 23

Golimumab -Simponi Targets TNF-a

Certolizumab pegol - Cimzia Targets TNF-a

Secukinumab - Cosentyx Targets interleukin 17

Ixekizumab - Taltz Targets interleukin 17

Brodalumab - Siliq / Kyntheum Targets interleukin 17

Guselkumab-Tremfya Targets interleukin 23

Abatacept-Orencia Targets TNF *Only used for psoriatic arthritis.

Tildrakizumab - Ilumya / Ilumetri Targets interleukin 23

Humira: Is taken by injection under the skin once every two weeks. The patient can do this at home themselves. Treatment will usually be stopped if there is no improvement after 16 weeks.

Patients should be checked for tuberculosis (TB) before taking Humira and you should have regular blood tests.

Who should not take Humira?
*People with active serious infections, history of recurrent infections or a history of heart failure
*People with multiple sclerosis or other similar types of demyelinating neurological diseases
*Children – the medication has not been approved for children
*Caution is advised for the elderly, due to the already increased risk of infection for this age group
*Pregnant women should not be treated with Humira and women should not breastfeed during treatment with Humira

What should I watch for AFTER starting HUMIRA?
*Serious infections. These include TB and infections caused by viruses, fungi, or bacteria. Symptoms related to TB include cough, low-grade fever, weight loss, or loss of body fat and muscle.
* Allergic reactions. Signs of a serious allergic reaction include skin rash, a swollen face, or trouble breathing.
* Hepatitis B virus reactivation in patients that carry the virus in their blood. Symptoms include feeling unwell, poor appetite, tiredness, fever, rash, or joint pain.
* Nervous system problems. Signs and symptoms include numbness or tingling, problems with your vision, weakness in your arms or legs, and dizziness.
* Blood problems. Symptoms include a fever that does not go away, bruising or bleeding very easily, or looking very pale.
* New heart failure or worsening of heart failure you already have. Symptoms include shortness of breath or swelling of your ankles or feet, or sudden weight gain.
* Immune reactions including a lupus-like syndrome. Symptoms include chest discomfort or pain that does not go away, shortness of breath, joint pain, or rash on your cheeks or arms that gets worse in the sun.
* Psoriasis (new or worsening). Symptoms include red scaly patches or raised bumps that are filled with pus.

Common side effects of HUMIRA include injection site reactions (redness, rash, swelling, itching, or bruising), upper respiratory infections (sinus infections), headaches, rash, and nausea. These are not all of the possible side effects with HUMIRA. Tell your doctor if you have any side effect that bothers you or that does not go away.

humira.com

Tips on using the bio treatments: Biological Treatments For Psoriasis

Enbrel: Is taken by injection under the skin twice per week. The patient can do this at home themselves. Treatment will usually be stopped if there is no improvement after 12 weeks.

Patients should be checked for tuberculosis (TB) before taking Enbrel and you should have regular blood tests.

Who should not take Enbrel ?
People with active infections should not start Enbrel.
The use of Enbrel in pregnant women is not recommended and women of child bearing potential should be advised not to get pregnant during Enbrel therapy.

What should I watch for AFTER starting Enbrel?
Dizziness; headache; pain, redness, itching, bruising, or swelling around the injection site.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); butterfly rash (rash on nose and cheeks); chest pain or discomfort; decreased mental alertness; fast heartbeat; fever, chills, or sore throat; general feeling of being unwell; increased or painful urination; mental or mood changes; new or worsening cough; numbness or tingling throughout your body; rapid breathing; rash on your face and arms that gets worse in the sun; seizures; shortness of breath; swelling of the arms or legs; weight loss; swelling of the lymph nodes; symptoms of liver problems (eg, yellowing of the skin or eyes, dark urine, pale stools); unusual bruising or bleeding; unusual lumps; unusual nausea, vomiting, stomach pain, or diarrhea; unusual tiredness or weakness; unusually pale skin; vision problems; weakness in the arms or legs.

enbrel.com

Tips on using the bio treatments: Biological Treatments For Psoriasis

Remicade: Is given by infusion in the vein and can take two hours to recieve the full dose. It will be done in hospital and after the first dose you will get another at week two and week six, then every 6 weeks.
Treatment will usually be stopped if there is no improvement after 10 weeks.

Patients should be checked for tuberculosis (TB) before taking Remicade and you should have regular blood tests.

Who should not take Remicade ?
• People with active serious infections or a history of heart failure
• Children – the medication has not been approved for children
· Caution is advised for the elderly, due to the already increased risk of infection for this age group
• Pregnant women should not be treated with Remicade and women should not breastfeed during treatment with Remicade

What should I watch for AFTER starting Remicade ?
Remicade can cause serious allergic reactions during the infusion, and for 2 hours afterwards. For this reason a doctor or nurse will monitor you during this period. You may also be given other medications to treat or prevent reactions to the infliximab.

Infections (such as TB, blood infections, pneumonia)—fever, tiredness, cough, flu, or warm, red or painful skin or any open sores. REMICADE® can make you more likely to get an infection or make any infection that you have worse.
Lymphoma, or any other cancers in adults and children.
Heart failure—new or worsening symptoms, such as shortness of breath, swelling of your ankles or feet, or sudden weight gain.
Reactivation of HBV—feeling unwell, poor appetite, tiredness, fever, skin rash and/or joint pain.
Liver injury—jaundice (yellow skin and eyes), dark brown urine, right-sided abdominal pain, fever, or severe tiredness.
Blood disorders—fever that doesn't go away, bruising, bleeding or severe paleness.
Nervous system disorders—numbness, weakness, tingling, changes in your vision or seizures.
Allergic reactions during or after the infusion—hives, difficulty breathing, chest pain, high or low blood pressure, swelling of face and hands, and fever or chills.
Lupus-like syndrome—chest discomfort or pain that does not go away, shortness of breath, joint pain, rash on the cheeks or arms that gets worse in the sun. The more common side effects with REMICADE® are respiratory infections (that may include sinus infections and sore throat), headache, rash, coughing and stomach pain.
Psoriasis—new or worsening psoriasis such as red scaly patches or raised bumps on the skin that are filled with pus.

remicade.com

Tips on using the bio treatments: Biological Treatments For Psoriasis

Stelara: Is taken by injection under the skin. After the first dose you will receive another on week 4 then every 12 weeks. Treatment will usually be stopped if there is no improvement after 12 weeks.

Patients should be checked for tuberculosis (TB) before taking Stelara and you should have regular blood tests.

Who should not take Stelara ?
• People who are allergic to ustekinumab or any of the other ingredients of Stelara
• People with active serious infections
• People requiring live vaccines (inactivated or non-live vaccines, speak to your doctor if you have any concerns on this topic)
• Children – the medication has not been approved for children
• Caution is advised for the elderly, due to the already increased risk of infection for this age group
• Pregnant women, or women trying to become pregnant (Stelara must be stopped for 15 weeks before conception)
• If you are breast-feeding or if you plan to breast-feed while using Stelara, your doctor will decide whether you should use this medicine.

What should I watch for AFTER starting Stelara ?
* fever, sweats, or chills
* muscle aches
* cough
* shortness of breath
* blood in your phlegm
* weight loss
* warm, red, or painful skin or sores on your body
* diarrhea or stomach pain
* burning when you urinate or urinate more often than normal
* feel very tired
* are being treated for an infection
* get a lot of infections or have infections that keep coming back

stelarainfo.com

Tips on using the bio treatments: Biological Treatments For Psoriasis

Simponi: Is taken by injection under the skin once a month. The patient can do this at home themselves. Treatment will usually be stopped if there is no improvement after 16 weeks.

Patients should be checked for tuberculosis (TB) before taking Simponi and you should have regular blood tests.

Who should not take Simponi ?
if you have any kind of infection. Tell your doctor if you are prone to or have a history of infections or have diabetes, HIV or a weak immune system. You should also tell your doctor if you are currently being treated for an infection or if you have or develop any signs of an infection such as:
* fever, sweat, or chills * muscle aches * cough * shortness of breath * blood in phlegm * weight loss * warm, red, or painful skin or sores on your body * diarrhea or stomach pain * burning when you urinate or urinate more than normal * feel very tired.

What should I watch for AFTER starting Simponi?
* feel very tired * skin or eyes look yellow * little or no appetite * vomiting * muscle aches * dark urine * clay-colored bowel movements * fevers * chills * stomach discomfort * skin rash

simponi.com

Tips on using the bio treatments: Biological Treatments For Psoriasis

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*Simponi Aria is given intravenously

Cimzia: Is taken by injection under the skin and after tuition the patient can do this themselves, see first post in this thread for some tips. The recommended starting dose of Cimzia for adult patients is 400 mg (given as 2 subcutaneous injections of 200 mg each) at weeks 0, 2 and 4. After the starting dose, the recommended maintenance dose of Cimzia for adult patients with psoriatic arthritis is 200 mg every 2 weeks.

Once clinical response is confirmed, an alternative maintenance dosing of 400 mg every 4 weeks can be considered. data suggest that clinical response is usually achieved within 12 weeks of treatment. Continued therapy should be carefully reconsidered in patients who show no evidence of therapeutic benefit within the first 12 weeks of treatment.

Patients should be checked for tuberculosis (TB) before taking Cimzia and you should have regular blood tests.

Who should not take Cimzia?
*People with active serious infections, history of recurrent infections.
*Children - Cimzia is not aproved for under 18s.
*Have or have had hepatitis B.
*Use the medicine Kineret® (anakinra), Orencia® (abatacept), Rituxan® (rituximab), or Tysabri® (natalizumab).
*You should also tell your doctor if you have lived in an area where there is an increased risk for getting certain kinds of fungal infections (histoplasmosis, coccidioidomycosis, blastomycosis). Your doctor should know these areas.
*Have or have had any type of cancer.
*Have congestive heart failure.

What should I watch for AFTER starting Cimzia?
*Heart Failure including new heart failure or worsening of heart failure you already have. Symptoms include shortness of breath, swelling of your ankles or feet, or sudden weight gain.
*Allergic Reactions. Signs of an allergic reaction include a skin rash, swelling or itching of the face, tongue, lips, or throat, or trouble breathing.
*Hepatitis B virus reactivation in patients who carry the virus in their blood.
*Feel unwell, Skin or eyes look yellow, Tiredness (fatigue), Poor appetite or vomiting, Pain on the right side of your stomach (abdomen).
*New or worsening nervous system problems, such as multiple sclerosis (MS), Guillain-Barre syndrome, seizures, or inflammation of the nerves of the eyes.
*Dizziness, numbness or tingling, problems with your vision, weakness in your arms or legs.
*Blood Problems. Your body may not make enough of the blood cells that help fight infections or help stop bleeding. Symptoms include a fever that doesn’t go away, bruising or bleeding very easily, or looking very pale.
*Immune reactions including a lupus-like syndrome. Symptoms include shortness of breath, joint pain, or a rash on the cheeks or arms that worsens with sun exposure.

The most common side effects of CIMZIA include: upper respiratory infections (flu, cold), rash, and urinary tract infections (bladder infections).

cimzia.com

Tips on using the bio treatments: Biological Treatments For Psoriasis

Cosentyx: Is taken by injection under the skin and after tuition the patient can do this themselves, see first post in this thread for some tips. The recommended starting dose of Cosentyx for adult patients is 300 mg at weeks 0, 1, 2, 3, and 4. After the starting dose, the recommended maintenance dose of Cosentyx for adult patients with psoriatic arthritis is 300 mg every 4 weeks. (Some patients may be on 150 mg maintenance dose) Treatment will usually be stopped if there is no improvement after 12 weeks.

Patients should be checked for tuberculosis (TB) before taking Cosentyx and you should have regular blood tests.

Who should not take Cosentyx?
*People with active serious infections, history of recurrent infections.
*Children - Cosentyx is not aproved for under 18s.
*You should consult your specialist if you are pregnant, planning a baby, or breast feeding

What should I watch for AFTER starting Cosentyx?
*Infections.
*Allergic Reactions.
*Fevers sweats chills, muscle aches, coughs, shortness of breath, blood in phlegm.
*Weight loss.
*Warm, red, or painful skin or sores on your body
*Diarrhoea or stomach pain, burning when you urinate or urinate more often than normal

The most common side effects of Cosentyx include: Cold symptoms, Upper repository infections, Diarrhoea.

cosentyx.com

Tips on using the bio treatments: Biological Treatments For Psoriasis

Taltz: is taken by injection under the skin and after tuition the patient can do this themselves, see first post in this thread for some tips. The recommended starting dose of Taltz for adult patients is 160 mg (two 80 mg injections) at Week 0, followed by 80 mg at Weeks 2, 4, 6, 8, 10, and 12, then 80 mg every 4 weeks. Treatment will usually be stopped if there is no improvement after 12 weeks.

Patients should be checked for tuberculosis (TB) before taking Taltz and you should have regular blood tests.

Who should not take Taltz?
*People with active serious infections, history of recurrent infections.
*Children - Taltz is not aproved for under 18s.
*You should consult your specialist if you are pregnant, planning a baby, or breast feeding

What should I watch for AFTER starting Taltz?
*Fever, sweats, or chills
*Muscle aches
*Cough
*Shortness of breath
*Blood in your phlegm (mucus)
*Weight loss
*Warm, red, or painful skin or sores on your body
*Diarrhea or stomach pain
*Burning when you urinate or urinate more often than normal

The most common side effects of Taltz include: Injection site reactions, upper respiratory infections, nausea, fungal infections.

taltz.com

Biological Treatments For Psoriasis

Temfya: Is taken by injection under the skin and after tuition the patient can do this themselves, see first post in this thread for some tips. The recommended starting dose of Tremfya is 100 mg at Week 0, Week 4 and every 8 weeks thereafter. Treatment will usually be stopped if there is no improvement after 12 weeks.

Patients should be checked for tuberculosis (TB) before taking Tremfya and you should have regular blood tests.

Who should not take Tremfya?
*People with active serious infections, history of recurrent infections.
*Children - Tremfya is not aproved for under 18s.
*You should consult your specialist if you are pregnant, planning a baby, or breast feeding.

What should I watch for AFTER starting Tremfya?
*Infections.
*Allergic Reactions.
*Fevers sweats chills, muscle aches, coughs, shortness of breath, blood in phlegm.
*Weight loss.
*Warm, red, or painful skin or sores on your body
*Diarrhoea or stomach pain, burning when you urinate or urinate more often than normal

The most common side effects of Tremfya include: Upper respiratory infections, headache, injection site reactions, arthralgia, diarrhoea, gastroenteritis, tinea infections, and herpes simplex infections.

tremfya.com

Tips on using the bio treatments: Biological Treatments For Psoriasis