Biologics target specific aspects of the body’s immune response to interrupt the inflammatory process that leads to psoriatic arthritis. One class of biologics, called TNF inhibitors, works by blocking the action of tumor necrosis factor-alpha (TNF-alpha), a protein that triggers inflammation in psoriatic arthritis. Common TNF-alpha inhibitors include Enbrel (etanercept), Humira (adalimumab), Remicade (infliximab), Cimzia (certolizumab), and Simponi (golimumab). There are other classes of biologic drugs that treat a whole host of autoimmune diseases, and some of these have been approved by the Food and Drug Administration specifically for psoriatic arthritis. These include Stelara (ustekinumab), which targets interleukin-12/23, and Cosentyx (secukinumab), which inhibits interleukin-17A. RELATED: What Psoriatic Arthritis Really Feels Like In light of the ongoing COVID-19 pandemic, you may be concerned that biologic therapy for psoriatic arthritis could put you at a higher risk of contracting the novel coronavirus. While the effect of biologics on COVID-19 risk is not yet completely understood, these drugs do not appear to meaningfully alter the risk of getting the virus or having a worse outcome, according to the National Psoriasis Foundation (NPF). The NPF and the AAD currently recommend that people taking biologic therapy for psoriatic arthritis continue as directed unless they have symptoms of COVID-19 or test positive for the virus. Because biologics for psoriatic arthritis can activate a lung infection called latent tuberculosis (TB) and worsen the liver infections hepatitis B and C, you’ll need to be tested for these conditions before you start taking these drugs, says Dr. Carter. Make sure you have any other recommended screenings and vaccinations as well. Once you start a biologic therapy or another immunosuppressant medication, be sure to alert your doctor if you experience any signs of an infection — you might need to stop taking the drug until you treat the infection and recover well. RELATED: 10 Natural Remedies for Psoriatic Arthritis
- Get your yearly flu shot. The Centers for Disease Control and Prevention (CDC) recommends that everyone age six months and older get a flu shot. If you are taking biologics for psoriatic arthritis, you must be vaccinated with a shot (which contains inactivated or killed virus) instead of a nasal spray (which contains weakened versions of the live virus).
- Avoid close contact with anyone who is or might be sick. Keep at least six feet away from anyone in your home who is currently sick. When out in public, stay at least six feet away from people who are not in your household.
- Wear a mask that covers your nose and mouth in public. This is especially important when social distancing measures are difficult to maintain, says the CDC.
- Wash your hands thoroughly and regularly. This means with soap and water, and for long enough to remove germs. Lather up for about 20 seconds, or the length of time it takes to sing “Happy Birthday” to yourself twice, and then rinse and dry your hands on a clean towel. Here’s when you should wash:
Before and after preparing foodBefore eatingAfter using the toiletAfter coughing, sneezing, blowing your nose, or disposing of other bodily fluidsAfter caring for or coming in contact with someone who’s sickBefore and after caring for a woundAfter handling an animal, animal waste, or animal care products, such as pet foodAfter emptying trash cans or taking out the trash
- Use hand sanitizer. If soap and water aren’t available, use hand sanitizer that’s at least 60 percent alcohol. Cover all hand surfaces and let the gel dry thoroughly.
- Avoid touching your eyes, mouth, and nose. Unless you’ve just washed your hands thoroughly, don’t touch your face.
- Cover open wounds. Make sure any sores or cuts are clean and protected by a bandage.
- Tell other healthcare providers that you take a biologic drug. Let your dentist, dermatologist, and any other healthcare workers know about the medication you take, so they can take additional infection-prevention steps when they treat you.
- Get the COVID-19 vaccine when it becomes available to you. Taking biologics for psoriatic arthritis does not mean it is unsafe for you to get one of the messenger-RNA-based COVID-19 vaccines developed by Pfizer or Moderna, states the NPF. Even if you follow all these precautions, there’s still a chance you may develop some kind of infection. Among the symptoms that merit a phone call to your doctor or an office visit are fever, cough, rash, or burning when you urinate, says Carter. If you aren’t sure if your symptoms signal an infection, err on the side of caution and call your physician. Additional research by Julia Califano.
