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Treatment Comparison for Psoriasis

If you are new to psoriasis or have had psoriasis for some time, you may find you need to learn more about your treatment options (especially since treatment plans change from time to time.) Use this quick reference treatment chart to learn about risks, monitoring, side effects, duration and frequency for light therapy, systemic and biologic treatments. Use this information to help work with your health care provider to determine what is the best treatment plan for you.

Systemic & Light Therapy | Biologics

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Traditional systemic treatments and light therapy
Treatment type
for moderate to severe psoriasis and psoriatic arthritis
Light therapy Methotrexate Cyclosporine Soriantane
Indication
which diseases the drug treats
Psoriasis Psoriasis
Psoriatic arthritis
Psoriasis Psoriasis
Method of delivery
how the drug is given or taken
Exposure to ultraviolet light B (UVB) or ultraviolet light A (UVA) in doctor's office or home setting Orally via liquid or pill or by subcutaneous injection Orally via liquid or capsule Orally via capsule
Frequency
how often the drug must be taken
Up to 3 times per week Once per week; doses may be divided and taken three times over 24 hours Daily Daily
Duration
how long the drug must be taken
Variable, averaging 12 weeks Continuously to maintain results Up to one year maximum Continuously to maintain results
Common side effects
A side effect is an undesirable secondary effect of a medication. Side effects may vary for each individual depending on disease state, age, weight, gender, ethnicity and general health. All medications have side effects.
  • Itching
  • Redness of the skin
  • Nausea
  • Tiredness
  • Difficulty sleeping
  • Light headedness
  • Mouth ulcers
  • Vomiting
  • Headache
  • Easy bruising
  • Fever
  • Chills
  • Decreased kidney function
  • Headache
  • High blood pressure
  • High cholesterol
  • Skin sensitivity
  • Flu-life symptoms
  • Upset stomach
  • Tiredness
  • Musculoskeletal pain
  • Hair loss
  • Chapped lips
  • Dry skin
  • Bleeding gums
  • Peeling fingertips
  • Changes in blood-fat levels
  • Depression
  • Headache
  • Joint pain
Possible risks
The possible risks listed include serious adverse events that have been reported in association with these medications during and after clinical trials.
  • UVB: Skin burn, skin cancer
  • PUVA (UVA with drug psoralen): Skin cancer
  • Wrinkling
  • Itching
  • Nausea
  • Liver damage
  • Birth defects
  • Reduced white blood cell count
  • Increased toxicity in patients with poor kidney function
  • Kidney damage
  • Skin malignancies
  • Hypertension
  • Excessive hair growth
  • Tremor
  • Birth defects
  • Elevated cholesterol
  • Liver damage
Monitoring
Some adverse reactions can be detected by laboratory tests such as blood counts or liver function tests.
Monitoring for skin cancer
  • Complete blood count
  • Chem screen (liver, kidney function)
  • Occasional liver biopsies
  • Blood pressure monitoring
  • Kidney function monitoring
  • Liver enzyme testing
  • Cholesterol screening
  • Triglyceride monitoring

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Biologic treatments
Treatment type
for moderate to severe psoriasis and psoriatic arthritis
Enbrel
Etanercept
Humira
Adalimumab
Remicade
Infliximab
Simponi
Golimumab
Stelara
Ustekinumab
Indication
which diseases the drug treats
Psoriasis
Psoriatic arthritis
Psoriasis
Psoriatic arthritis
Psoriasis
Psoriatic arthritis
Psoriatic arthritis Psoriasis
Psoriatic arthritis
Method of delivery
how the drug is given or taken
Subcutaneous self-injection Subcutaneous self-injection Intravenous infusion by health care professional Subcutaneous self-injection Subcutaneous injection by a health care professional, or self-injection
Frequency
how often the drug must be taken
1-2 times weekly Every other week 3 times in first 6 weeks, then every 8 weeks Monthly Week 0, week 4, then every 3 months
Duration
how long the drug must be taken
Continuously to maintain results Continuously to maintain results Continuously to maintain results Continuously to maintain results Continuously to maintain results
Common side effects
A side effect is an undesirable secondary effect of a medication. Side effects may vary for each individual depending on disease state, age, weight, gender, ethnicity and general health. All medications have side effects.
  • Injection site reactions
  • Upper respiratory infections
  • Headaches
  • Injection site reactions
  • Upper respiratory infections
  • Headaches
  • Rash
  • Nausea
  • Respiratory infections
  • Headache
  • Rash
  • Coughing
  • Stomach pain
  • Upper respiratory infection
  • Nausea
  • Abnormal liver tests
  • Injection site reactions
  • High blood pressure
  • Bronchitis
  • Dizziness
  • Flu
  • Upper respiratory infections
  • Headache
  • Tiredness
  • Fatigue
Possible risks
The possible risks listed include serious adverse events that have been reported in association with these medications during and after clinical trials.
  • Serious infection
  • Nervous system problems
  • New or worsening heart failure
  • Allergic reactions
  • Lupus-like syndrome
  • Lymphoma
  • Hepatitis B reactivation
  • Skin cancer
  • Serious infection
  • Nervous system problems
  • New or worsening heart failure
  • Allergic reactions
  • Lupus-like syndrome
  • Lymphoma
  • Hepatitis B reactivation
  • Skin cancer
  • Serious infection
  • Nervous system problems
  • New or worsening heart failure
  • Allergic reactions
  • Lupus-like syndrome
  • Lymphoma
  • Hepatitis B reactivation
  • Skin cancer
  • Anaphylaxis
  • Liver enzyme abnormalities
  • Hepatitis B reactivation
  • New or worsening heart failure
  • Nervous system problems
  • Liver failure
  • Low blood count
  • Lupus-like symptoms
  • Allergic reactions
  • Lymphoma
  • Increased risk of serious infections
  • Reactivation of latent infections, including tuberculosis
  • Reversible Posterior Leukoencephalopathy Syndrome
  • Hypersensitivity reactions
Monitoring
Some adverse reactions can be detected by laboratory tests such as blood counts or liver function tests.
  • Tuberculosis screening
  • Annual blood count and liver function tests
  • Tuberculosis screening
  • Annual blood count and liver function tests
  • Tuberculosis screening
  • Annual blood count and liver function tests
  • Tuberculosis screening
  • Annual blood count and liver function tests
Tuberculosis screening

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National Psoriasis Foundation educational materials are medically reviewed and are not intended to replace the counsel of a physician. The Psoriasis Foundation does not endorse any medications, products or treatments for psoriasis or psoriatic arthritis and advises you to consult a physician before initiating any treatment.


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