While most medications are made by putting chemicals together, biologics are created by living human and animal cells. Biologics are proteins that work by changing interactions between cells that are causing the condition or disease. They can be tailor-made to treat a variety of different conditions. Although biologics have been around for decades, biologics designed to treat psoriasis are new.
Psoriasis is believed to be caused by an overactivity of certain immune system cells called T cells and messenger cells. It starts when some T cells receive a false message that makes them become "activated," move to the skin, and behave as if they were fighting an infection. This causes the skin to become inflamed (red, warm, irritated) and to overproduce skin cells. The extra skin cells build up and form plaques.
Biologics for psoriasis target only those parts of the immune system that are overactive. Some work by stopping T cells from becoming activated and/or from moving to the skin, or by reducing the number of activated T cells. Other biologics work by blocking immune system messengers involved in skin cell overproduction. Currently, there is one biologic available in Canada for the treatment of moderate to severe chronic plaque psoriasis: alefacept. It is believed to work by decreasing the number of activated T cells and by blocking T cell activation. It is given by intramuscular (into a muscle) injection.
Unlike most of the oral medications to treat psoriasis, biologics do not work by suppressing the immune system in general. Instead, they act specifically on the areas that are overactive. This may decrease the risk of infection, liver damage, and kidney damage. Another difference between some biologics and other psoriasis treatments is that the effects of some biologics (those that inhibit T cells that cause psoriasis), continue after the treatment has been stopped. This allows people to take "drug holidays" where they do not have to use the medication.
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