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Living Well with Psoriasis

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7 Possible Side Effects of Biologics for Psoriasis

Medically Reviewed By Philip Ngo, PharmD

Biologics for psoriasis may cause various side effects. More common side effects include flu-like symptoms such as fever or muscle aches. Some people may also experience symptoms around the injection site, including itching or swelling. Biologics are medications made from living cells, while other medications are made from chemicals. In rare cases, biologics may cause more serious side effects, such as neurological symptoms like headache or mood changes.

It’s also important to note that some people may experience few to no side effects. If you’re concerned about side effects, talk with a doctor about your treatment options.

This article discusses possible side effects of biologics for psoriasis.

1. Flu-like symptoms

An adult giving themselves an injection in the lower stomach
Photography by Yuko Hirao/Stocksy United

People receiving biologics for psoriasis may experience flu-like symptoms. These may include:

  • fever
  • chills
  • headache
  • body aches
  • Fatigue

Learn more about what to expect with biologics for psoriasis.

2. Injection site reactions

Biologics may also cause Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source symptoms around the site of the injection, such as:

  • pain
  • swelling
  • itching
  • bruising
  • skin discoloration
  • rash

3. Allergic reactions

Allergic reactions can occur with biologic medications and may cause symptoms like:

  • flushing
  • hives
  • breathing difficulties
  • nausea or vomiting

4. Increased risk of infection

Because biologics reduce the body’s typical immune system responses, people receiving the medications may be more susceptible to new infections. Biologics may also allow an existing infection, such as tuberculosis, to activate or reactivate.

Before trying biologics for psoriasis, your doctor may recommend undergoing tuberculosis screening and receiving vaccinations Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source for some infectious diseases, including:

  • hepatitis A or B
  • human papillomavirus
  • tetanus, diphtheria, and pertussis
  • influenza
  • pneumonia
  • COVID-19

During biologic therapy, you may also need to have your blood tested regularly to monitor for markers of infection.

Learn more about the pros and cons of biologics for psoriasis.

5. Neurological complications

According to a 2022 research review Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source , some studies have found that biologics for psoriasis may cause certain neurological complications, including:

  • headache or migraine
  • mood changes like anxiety and depression
  • sleep disturbances
  • vertigo

Less often, certain biologics called tumor necrosis factor-alpha (TNF-alpha) inhibitors have been associated with more serious conditions such as multiple sclerosis or Guillain-Barré syndrome.

The same review noted that some neurological issues may persist even after stopping treatment, but prompt discontinuation of the medication may give a person the best chance of full recovery.

6. Inflammatory bowel disease

Another 2022 review of studies Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source found that some medications in a class of biologics called interleukin 17 (IL-17) inhibitors may actually cause or worsen inflammatory bowel disease (IBD). The medications associated with new-onset IBD or IBD flares include:

  • secukinumab (Cosentyx)
  • ixekizumab (Taltz)
  • brodalumab (Siliq)

People with existing IBD or a higher risk of developing the condition should talk with their doctors about the risks of biologics for psoriasis.

7. Cancer

Some evidence suggests that biologic therapy for psoriasis may be associated with an increased risk of certain cancers. For example, a large 2023 study Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source evaluating more than 190,000 people from Korea with psoriasis found that TNF-alpha inhibitors may increase the risk of overall cancer, including lymphoma.

A specific TNF-alpha inhibitor called adalimumab (Humira) may also increase Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source the risk of non-melanoma skin cancer in people with light skin.

It’s important to note that the risk of serious side effects like cancer is low, and more research is needed Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source to determine the long-term safety of biologics for psoriasis.

When to see a doctor

If you notice any unusual symptoms right after receiving a biologic medication or in the following days or weeks, contact your doctor. They may be able to adjust your dose or recommend an alternative medication.

Other frequently asked questions

Philip Ngo, PharmD, reviewed the answers to these common questions about biologics for psoriasis.

How long do you stay on biologics for psoriasis?

The amount of time a person may need to be on biologics for psoriasis can vary. For example, you may not be on a biologic for very long if you experience adverse effects or it stops working for you. If a biologic is effective and doesn’t cause severe side effects, you may be on it long-term to manage your symptoms and avoid possible recurrences after discontinuation.

Learn more about when it may be time to switch biologics for psoriasis.

What is the safest biologic for psoriasis?

There isn’t one single biologic that has been proven to be the safest for everyone. Talk with your doctor about which biologic might be the safest for you.

Summary

Some people on biologics for psoriasis may experience few to no adverse effects. Others may experience mild side effects, such as flu-like symptoms or symptoms around the injection site. Serious side effects are rare.

Contact your doctor if you’re concerned about possible side effects of biologics for psoriasis.

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Medical Reviewer: Philip Ngo, PharmD
Last Review Date: 2024 Feb 1
View All Living Well with Psoriasis Articles
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