Biologic Drugs for Psoriatic Arthritis

One common treatment for psoriatic arthritis (PsA) is disease-modifying antirheumatic drugs (DMARDs). DMARDs reduce inflammation. They can also help prevent long-term joint damage, which can cause disability.^1,2

There are 3 types of DMARDs:^1,2

• Traditional (or non-biologic)
• Biologic
• Target-specific

Biologic DMARDs (biologics) are often used to treat moderate to severe PsA. Biologics may also be prescribed when a person’s PsA has not improved with other treatment options. These drugs can be taken on their own or alongside other PsA treatments like phototherapy.^1,2

How do biologics work?

Biologics are drugs made from living cells. These cells can come from parts of the blood, proteins, viruses, or tissue. The process of making biologics turns products made from cells into drugs that can prevent, treat, and cure disease. These are different from most traditional drugs. ^1,2

Biologics target specific parts of the immune system. Some target cytokines like tumor necrosis factor-alpha (TNF-alpha), interleukin 17 (IL-17), or interleukin 23 (IL-23). Cytokines are proteins that play a role in the inflammatory response. Blocking them may slow or stop inflammation.^1,2

Decreasing inflammation is helpful for people with autoimmune or inflammatory conditions like PsA. It may help improve symptoms and prevent further joint damage.^1,2

Other biologics target T cells and block their activation. T cells are immune system cells that also play a role in inflammation. Biologics are also used to treat other inflammatory conditions, such as rheumatoid arthritis, plaque psoriasis, and ankylosing spondylitis.^1-7

Examples of biologics for PsA

A variety of biologics are used to treat PsA. They can be grouped based on their specific target in the body.

Examples of biologics that target TNF-alpha include:^1,2

• Cimzia^® (certolizumab pegol)
• Enbrel^® (etanercept)
• Humira^® (adalimumab)
• Remicade^® (infliximab)
• Simponi^® (golimumab)
• Simponi Aria^® (golimumab)

Examples of biologics that target IL-17 include:^1,2

• Cosentyx® (secukinumab)
• Taltz® (ixekizumab)

Examples of biologics that target IL-23 include:^1,2,8

• Tremfya^® (guselkumab)
• Stelara^® (ustekinumab; also targets IL-12)

The biologic Orencia^® (abatacept) is unique. It targets T cells.^1,2

What are the possible side effects?

Side effects can vary depending on the specific drug you are taking. The most common side effects of biologics for PsA include:^3-7

• Upper respiratory infection
• Sinus infection
• Runny nose
• Headache
• Rash
• Diarrhea
• Nausea
• Injection site reactions (redness, itching, or swelling)

These are not all the possible side effects of biologics. 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

Because they decrease inflammation and immune system response, biologics can increase the risk of infection. Serious infections can become life-threatening. Do not start taking a biologic if you have an active infection.^3-7

Before you start a biologic, your doctor may test you for tuberculosis (TB) and hepatitis B. Starting a biologic when you have TB or hepatitis B can lead to severe infection. If you are at high risk for infection on a biologic, you may need to take other drugs alongside it. If you have fevers, chills, muscle aches, or other symptoms of an infection, tell your doctor right away.^3-7

In some cases, biologic drugs may impact a person’s blood cell counts or increase the risk of cancer. Your doctor can tell you if your drug has these risks.^3-7

Although they are rare, serious allergic reactions can occur with biologics. Tell your doctor about any allergic reactions you have had to drugs in the past. Signs of an allergic reaction include hives, trouble breathing, abdominal pain, and swelling of the face, tongue, or lips.^3-7

Biologics can also impact a person’s ability to safely receive live vaccines. However, most vaccines are not live and can still be taken. Talk with your doctor before starting a biologic if you have recently received or will soon receive a vaccine.^3-7

Many biologics can interact with other drugs. Before beginning treatment for PsA, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.