Treatment of psoriasis with biologicals

A condition that is often seen as contagious by people who do not know it. Very annoying for the person who has it, even more annoying is the burden it causes him even more. A fairly new treatment is that with biologicals.


  • What are biologicals?
  • When am I eligible for biologicals?
  • What does treatment with biologicals entail?

Psoriasis is a skin condition that is generally very annoying. It causes a lot of flaking, is very itchy and looks bad to others. It is a chronic autoimmune disease that causes an inflammatory response in the skin. This causes the skin to divide too quickly, creating the red underlayer with the white layer of flakes on top.

What are biologicals?

Biologicals are artificially created proteins with the same structure as the proteins that occur in our own body. Most biologicals are antibodies against the proteins that occur in our own body, the so-called T cells. The biologicals can bind to too many of these T cells, which are largely responsible for inflammatory processes, and thus inhibit inflammation.

When am I eligible for biologicals?

Because treatment with biologicals is quite expensive, not everyone with psoriasis is immediately treated with this medication. You are registered for this treatment when the psoriasis is very severe (this is calculated as a percentage of the body) and does not respond to other treatments such as hormone ointments or light therapy. But even if these requirements are met, you are not there yet. Before treatment is started, a lot must first be investigated, for example, it must be tested whether you do not have TB or Hepatitis and it is important for women to know whether she is pregnant.

What does treatment with biologicals entail?


Treatment can be done with the following biologicals:

  • Humira (adalimumab)
  • Enbrel (etanercept)
  • Remicade (infliximab)
  • Stelara (ustekinumab)

Because the biologicals have not been on the market for very long, it cannot yet be said which of them works best. Usually Humira or Enbrel is started first. Due to the ease of use of Humira, this is usually chosen.

The flu

An important note is that using this medication makes you more susceptible to infections due to switching off (some of) the T cells and it is therefore strongly recommended to get the flu shot as soon as it is available. If you still get the flu, it is wise to contact your doctor to possibly start treatment with Tamiflu to make it easier to combat the flu.


It differs slightly in how the treatments work with the different biologicals. They are administered by the patient himself or by infusion. This is why Humira is currently used most often. As a patient, you can administer this yourself once every two weeks, but at the beginning of the treatment the drug will have to be administered slightly more frequently to build up the drug. This is administered using the same system as injecting insulin into patients with diabetes and is therefore friendly and easy to use.

Side effects

Side effects that can often occur when using biologicals are:

  • Flu-like symptoms
  • Infections (often of the upper respiratory tract)
  • Injection site reactions

These side effects are described as mild to moderate. The side effects that may occur with long-term use of these medicines are not yet known because these medicines have only been available for a relatively short time.