Many types of biologic can treat PSA. Different types may work differently in different people. Their side effects can also vary. It’s important to weigh up your options and choose one that is right for you.

Psoriatic arthritis, or PsA, causes swelling, stiffness, and pain in your joints. There is no cure for PsA, but lifestyle changes and medications can help manage symptoms.

Common medications that treat PsA include:

  • nonsteroidal anti-inflammatory drugs
  • disease-modifying antirheumatic drugs
  • biologics

Biologics are the newest and strongest option available to treat PsA. Guidelines recommend these drugs as one of the first-line treatment options for PsA.

Inflammation typically causes the swelling, stiffness, and joint pain that is seen in PsA.

Each biologic for the treatment of PsA is designed to target a particular pathway in the body that creates inflammation. This is different than more traditional drugs, which affect multiple steps in the immune system.

Depending on your PsA symptoms and medical history, your doctor may recommend a biologic for your symptom relief.

Non-biologic medications are made of synthetic components. That is, you won’t find them in nature.

These drugs are created in a laboratory from nonbiological materials. For example, though aspirin is derived from willow bark, it is made from synthetic materials, as you will not see aspirin anywhere naturally.

Biologics, on the other hand, are made up of biological components, such as whole cells, enzymes, antibodies, and other elements. Scientists use these to create a drug with a very specific function.

Chances are, you’ve already been exposed to medical technology made from components found in nature.

If you’ve ever had a vaccine or received a blood transfusion, you’ve had a medical treatment that used biological materials.

Because biologics are more exact when targeting cells and mimic molecules found naturally in the body, they are generally more effective. They may also have fewer side effects for this reason.

Several biologic options can treat PsA. These drugs can be grouped together based on how they affect the immune system.

TNF-alpha inhibitors

Tumor necrosis factor-alpha (TNF-alpha) is a protein that leads to inflammation. People with PsA have excessive amounts of TNF-alpha in their skin or joints.

These five drugs are designed to block this protein:

They work by stopping the excessive growth of skin cells and inflammation that can cause damage in joint tissue.

TNF-alpha inhibitors are often the first medication doctors suggest for the treatment of PsA.

IL-12, IL-23, and IL-17 inhibitors

Interleukin-12, interleukin-17, and interleukin-23 are different proteins associated with inflammation. Five biologics are currently available that interfere with the activity of these proteins or their receptors.

These medications reduce the effect of interleukins:

T-cell inhibitors

In people who have arthritis, an immune cell called T-lymphocyte cells (T cells) is activated, which can cause more of these cells to be produced. This is also known as “proliferation”. So, some people with arthritis will develop an excess of T cells.

We all need these immune cells. But in large amounts, they can produce chemicals that lead to joint damage, pain, and swelling.

Orencia (abatacept) is a medication that affects T cells. It doesn’t reduce the number of T cells, but it prevents them from producing a chemical that causes symptoms.

JAK kinase inhibitor

Xeljanz (tofacitinib) is another medication approved for PsA.

It’s a Janus kinase (JAK) inhibitor. This is a small molecule that blocks a particular pathway involved in the immune system’s inflammation response.

This medication is not technically a biologic, but your doctor may talk with you about it. It’s often grouped together with biologics in discussions about more targeted agents for autoimmunity.

Each PsA biologic is different, and each has its own potential side effects.

However, there are also similarities in this class of drugs. The most common side effect for all biologics is an increased risk of opportunistic infections. This is because biologics suppress the immune system.

Opportunistic infections are uncommon infections that take advantage of a weakened immune system.

Another side effect can be flu-like symptoms or respiratory infections. If you notice any signs of infection, make sure to get advice from a healthcare professional.

Since biologics are given by injection or via an intravenous (IV) solution, you may also experience discomfort where the needle enters your skin.

Serious side effects from biologics include such as blood disorders or cancer. Another more serious side effect of TNF-alpha inhibitors is new or worsening heart failure.

For these reasons, it’s a good idea to maintain a strong relationship with your doctor that focuses on open communication.

Together, you can talk about and decide whether a biologic is the right treatment for your PsA.

Biologics are recommended for those living with moderate to severe PsA. But some people aren’t suitable candidates for biologics.

That’s because the drug’s side effects may do more harm than good in certain people.

For example, if you have a compromised immune system or active infection, it’s best to avoid biologics to treat your PsA. This is because these drugs suppress the immune system and can be unsafe if yours is already compromised in some way.

The cost and out-of-pocket expenses for biologics can also be a barrier for some people.

Biologics are targeted treatment options for those living with moderate to severe PsA. They are now considered a first-line therapy for treating PsA.

However, not everyone will be suitable for treatment with biologics. And each one may have different potential side effects.

Talk with your doctor about whether biologics meet your treatment needs and are suitable for you based on your health history.