What are systemic medications for psoriasis?

Understanding Systemic Medications for Psoriasis

Psoriasis is a chronic autoimmune condition that primarily affects the skin, leading to the formation of red, itchy, and scaly patches. While topical treatments and phototherapy are commonly used for mild cases, systemic medications are often required for moderate to severe psoriasis. These medications work throughout the entire body, rather than just targeting the affected skin areas.

Types of Systemic Medications

Systemic medications for psoriasis can be broadly categorised into traditional systemic treatments and biologic drugs. The choice of medication depends on various factors such as the severity of the disease, the patient's overall health, and their response to previous treatments.

Traditional Systemic Treatments

Methotrexate is one of the most commonly prescribed traditional systemic drugs for psoriasis. It works by suppressing the immune system to reduce inflammation and slow down the rapid growth of skin cells. While effective, it requires regular monitoring due to potential side effects, including liver damage.

Cyclosporine is another traditional systemic medication that helps control severe cases of psoriasis by inhibiting certain immune cells. It is typically used short-term due to risks such as kidney damage and high blood pressure.

Acitretin, a retinoid, is prescribed for psoriasis by helping normalize skin cell growth. It is especially useful for pustular or erythrodermic psoriasis, but it is not suitable for pregnant women due to teratogenic effects.

Biologic Drugs

Biologic drugs have revolutionised the treatment of severe psoriasis. These medications target specific components of the immune system, offering a more targeted approach with fewer systemic side effects. Common biologics include adalimumab, etanercept, and infliximab, which inhibit tumour necrosis factor-alpha (TNF-alpha), a key pro-inflammatory cytokine.

Other biologics, such as ustekinumab, target different pathways, specifically interleukin-12 and interleukin-23. Newer biologics like secukinumab and ixekizumab focus on interleukin-17, providing effective options for patients who do not respond to other treatments.

Considerations and Monitoring

When using systemic medications for psoriasis, regular monitoring by healthcare professionals is crucial to manage potential side effects and assess the treatment's effectiveness. Blood tests, liver function tests, and kidney function assessments are often part of routine monitoring.

Due to the complexity of psoriasis and its treatments, patients should work closely with dermatologist specialists to tailor a treatment plan that suits their individual needs. By understanding the role of systemic medications, patients can make informed decisions with their healthcare providers to effectively manage their psoriasis.