Psoriasis affects over 7.5 million people in the US, causing inflamed, scaly skin patches that can be painful and persistent. While some manage symptoms with creams or pills, moderate to severe cases often require stronger treatments. Injections provide a more targeted approach, helping to reduce inflammation and slow excessive skin cell growth.
This guide explores several injections for psoriasis that can be self-administered at home, making long-term treatment more manageable. We’ll cover how they work, dosing frequency, and key factors to consider when choosing a treatment.
Key Takeaways
- Injections for psoriasis are highly effective for moderate to severe cases, offering significant symptom relief.
- Different drug classes target different inflammatory pathways. TNF blockers suppress general inflammation, while newer IL-12, IL-17, and IL-23 inhibitors offer more precise mechanisms with potentially fewer side effects.
- Dosing frequency varies widely among injections. Some require frequent injections (weekly or biweekly), while others need only four injections per year after the initial doses, making adherence easier for some patients.
- Most biologic injections for psoriasis demonstrate high PASI 75, 90, and even 100 rates, meaning they significantly reduce psoriasis severity, with some achieving near-complete skin clearance in long-term studies.
- Many psoriasis injections are also used to treat psoriatic arthritis, Crohn’s disease, or ulcerative colitis, making them beneficial for patients with overlapping conditions.
7 FDA-Approved Injections for Psoriasis
Several injections for psoriasis are available, each with distinct characteristics:
Active Ingredients: Adalimumab
Drug Class: Tumor Necrosis Factor (TNF) Blocker
Dosage Form and Strength:
- Humira Pen: 80 mg and 40 mg
- Prefilled Syringe: 80 mg, 40 mg, 20 mg, and 10 mg
Dosage Frequency for Psoriasis: Once every 2 weeks
Common Side Effects: Infections (e.g. upper respiratory, sinusitis), injection site reactions, headache, and rash.
Approved Indications:
- Rheumatoid Arthritis
- Polyarticular Juvenile Idiopathic Arthritis in patients 2+
- Psoriatic Arthritis
- Ankylosing Spondylitis
- Crohn’s Disease in adults and children 6+
- Ulcerative Colitis in adults and children 5+
- Plaque Psoriasis
- Hidradenitis Suppurativa in patients 12+
- Non-infectious Uveitis in adults and children 2+
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How does Humira work for Psoriasis?
Humira (adalimumab) is a biologic injection for psoriasis that blocks TNF-alpha, a protein that causes inflammation and rapid skin cell growth in psoriasis. By reducing TNF-? activity, it helps clear plaques, easing redness, scaling, and thickening.
Is Humira effective for Psoriasis?
A real-world study on Humira’s effectiveness in psoriasis showed that 84% of patients achieved PASI 75 (a 75% reduction in psoriasis severity) after 12 months. After 8 years, 88% maintained these results, demonstrating long-lasting benefits.
Another study examined how well Humira treats moderate to severe plaque psoriasis on the hands and feet and whether its effects last. At week 16, 31% of patients on Humira had clear or almost clear skin. Among those who improved, 80% maintained their results for up to 28 weeks.
Active Ingredients: Etanercept
Drug Class: Tumor Necrosis Factor (TNF) Blocker
Dosage Form and Strength:
- Prefilled Syringe: 25 mg and 50 mg
- SureClick® Autoinjector: 50 mg
- Single-dose Vial: 25 mg
- Multiple-dose Vial for reconstitution: 25 mg
- Enbrel Mini® cartridge for use with the AutoTouch®: 50 mg
Dosage Frequency for Psoriasis:
- For adults: Twice-weekly injections for the first 12 weeks, followed by a maintenance dose once weekly.
- For pediatric patients: Once weekly
Common Side Effects: Infections and injection site reactions
Approved Indications:
- Rheumatoid Arthritis
- Polyarticular Juvenile Idiopathic Arthritis in patients 2+
- Psoriatic Arthritis in adults and children 2+
- Ankylosing Spondylitis
- Plaque Psoriasis in adults and children 4+
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How does Enbrel work for Psoriasis?
Enbrel (etanercept) is a biologic medication for plaque psoriasis that is used when topical treatments or phototherapy are not effective. It blocks TNF-alpha, a protein that causes inflammation and excessive skin cell growth, helping to reduce redness, scaling, and plaque thickening.
Is Enbrel effective for Psoriasis?
Both continuous and intermittent use of Enbrel injections for psoriasis helped reduce symptoms in real-world settings. In both groups, PASI scores (which measure psoriasis severity) dropped by 9.5-10 points, and the affected skin area shrank by 12% on average.
Patients new to Enbrel also reported a significant improvement in quality of life, with DLQI scores (measures how much psoriasis affects daily life) decreasing by 5.8 points.
A separate study focused on children with plaque psoriasis. By week 16:
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- 90.7% of children had at least a 50% improvement (PASI 50)
- 79.1% reached PASI 75, indicating a strong response.
- 46.5% achieved PASI 90, meaning nearly clear skin.
- BSA scores dropped significantly, meaning less of the body was affected
Additionally, the CDLQI score dropped from 17.4 to 5.4, showing that children experienced much less impact from psoriasis after treatment with Enbrel.
Active Ingredients: Ustekinumab
Drug Class: Interleukin-12 and -23 Antagonist
Dosage Form and Strength:
- Prefilled Syringe: 45 mg and 90 mg
- Single-dose Vial: 45 mg
Dosage Frequency for Psoriasis:
- For adults and pediatric patients: Initial dose at week 0, followed by another dose at week 4, and then every 12 weeks thereafter.
Common Side Effects: Nasopharyngitis, upper respiratory tract infection, headache, and fatigue.
Approved Indications:
- Psoriatic Arthritis in adults and children 6+
- Crohn’s Disease
- Ulcerative Colitis
- Plaque Psoriasis in adults and children 6+
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How does Stelara work for Psoriasis?
Stelara (ustekinumab) blocks interleukin-12 (IL-12) and interleukin-23 (IL-23), two cytokines that drive inflammation and excessive skin cell growth in psoriasis. By inhibiting these proteins, Stelara reduces inflammation, slows rapid skin cell production, and clears psoriasis symptoms.
Is Stelara effective for Psoriasis?
A study on actual patient experiences showed that at the 16-week mark:
-
- 97% of the patients had at least a PASI50 response (50% symptom improvement)
- 57.6% reached PASI75 (75% improvement)
- 33.3% achieved PASI90 (90% or near-complete clearance)
These improvements continued over time, with similar response trends observed at 28, 52, 76, and 100 weeks. No major safety concerns were reported, reinforcing Stelara’s effectiveness and safety as a long-term psoriasis treatment.
Another study examined Stelara’s effectiveness in patients with inflammatory bowel disease (IBD) who were also receiving treatment for psoriasis or psoriatic arthritis. Since psoriasis and IBD share common inflammatory pathways, having one condition may increase the risk of developing the other.
In this study, 60.7% of patients achieved clinical remission by their last follow-up visit (average of 10.7 months). The probability of remission was estimated at 84.7% at 6 months and 63.9% at 12 months. These findings suggest that Stelara may be a valuable treatment option for patients with coexisting inflammatory diseases.
Active Ingredients: Secukinumab
Drug Class: Interleukin-17A Antagonist
Dosage Form and Strength:
- UnoReady® Pen: 300 mg
- Prefilled Syringe: 75 mg, 150 mg, and 300 mg
- Sensoready® Pen: 150 mg
Dosage Frequency for Psoriasis:
- For adults and pediatric patients: Initial dose at weeks 0, 1, 2, 3, and 4, followed by a maintenance dose every 4 weeks.
Common Side Effects: Nasopharyngitis, diarrhea, and upper respiratory tract infection.
Approved Indications:
- Psoriatic Arthritis in adults and children 2+
- Ankylosing Spondylitis
- Non-radiographic Axial Spondyloarthritis
- Enthesitis-related Arthritis in adults and children 4+
- Plaque Psoriasis in adults and children 6+
- Hidradenitis Suppurativa
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CONS:
How does Cosentyx work for Psoriasis?
Cosentyx (secukinumab) blocks interleukin-17A (IL-17A), a protein that triggers inflammation and causes excessive skin cell growth in psoriasis. By stopping IL-17A, Cosentyx reduces inflammation, slows down rapid skin cell turnover, and helps clear psoriasis plaques.
Is Cosentyx effective for Psoriasis?
The most recent real-world study on Cosentyx injection for psoriasis found that 54-65% of patients achieved PASI90 (90% skin clearance) by Week 24, and 46-63% maintained this response at Week 52. Additionally, 43-47% of patients had nearly clear skin (PASI less than or equal to 1) by Week 12, with 47-56% maintaining this level at Week 52.
Building on these findings, another study directly compared Cosentyx to other biologics and conventional systemic therapies for chronic plaque psoriasis in real-world clinical settings.
Here are the results:
| Treatment Group | % of patients who achieved PASI90 at month 3 | % of patients who achieved PASI90 at month 12 |
|---|---|---|
| Cosentyx | 59.7% | 60.8% |
| Conventional systemic therapies | 18.8% | 35.3% |
| Other biologics | 40.0% | 50.0% |
A separate real-world study, based on US dermatology electronic medical records, assessed long-term patient satisfaction with Cosentyx. At six months, 82.3% of patients agreed that the treatment was effective, and satisfaction remained stable at 12 months (81.7%), 18 months (83.3%), and 24 months (81.4%).
Active Ingredients: Ixekizumab
Drug Class: Interleukin-17A Antagonist
Dosage Form and Strength:
- Prefilled Autoinjector: 80 mg
- Prefilled Syringe: 20 mg, 40 mg, 80 mg
Dosage Frequency for Psoriasis:
- For adults: Initial doses are given every two weeks for the first 12 weeks, followed by a maintenance dose every 4 weeks.
- For pediatric patients: Initial dose at week 0, followed by a maintenance dose every 4 weeks.
Common Side Effects: Injection site reactions, upper respiratory tract infections, nausea, and tinea infections.
Approved Indications:
- Psoriatic Arthritis
- Ankylosing Spondylitis
- Non-radiographic Axial Spondyloarthritis
- Plaque Psoriasis in adults and children 6+
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How does Taltz work for Psoriasis?
Taltz (ixekizumab) works like Cosentyx for psoriasis. It blocks interleukin-17A (IL-17A), a protein that causes inflammation and excessive skin cell growth in psoriasis. By targeting IL-17A, Taltz reduces inflammation, slows down rapid skin turnover, and helps clear psoriasis plaques.
Is Taltz effective for Psoriasis?
A study using data from the US Taltz Customer Support Program found that by week 24, 63.1% had significant itch relief, 64.8% had less pain, and nearly 80% had psoriasis covering only 2% or less of their body, compared to 34.5% at the start.
In another study, researchers analyzed treatment survival with Taltz. Results showed that by week 16, the percentage of patients achieving:
-
- PASI100 (complete skin clearance): 54.1%
- PASI90 (90% improvement): 60.5%
- PASI less than or equal to 3 (minimal disease): 73%
By week 260 (five years), these numbers improved further:
-
- PASI100: 59.1%
- PASI90: 81.8%
- PASI less than or equal to 3: 95.5%
These findings confirm that Taltz provides strong and lasting effectiveness for psoriasis treatment.
6. Tremfya
Active Ingredients: Guselkumab
Drug Class: Interleukin-23 Antagonist
Dosage Form and Strength:
- One-Press Injector: 100 mg
- Prefilled Syringe: 100 mg and 200 mg
- Tremfya Pen: 200 mg
Dosage Frequency for Psoriasis: Initial dose given at weeks 0 and 4, followed by a maintenance dose every 8 weeks.
Common Side Effects: Upper respiratory infections, headache, injection site reactions, joint pain, bronchitis, diarrhea, gastroenteritis, tinea infections, and herpes simplex infections.
Approved Indications:
- Psoriatic Arthritis
- Ulcerative Colitis
- Plaque Psoriasis
PROS:
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How does Tremfya work for Psoriasis?
Tremfya (guselkumab) is a relatively new psoriasis injection treatment with an ongoing FDA review for pediatric psoriasis and juvenile psoriatic arthritis. It is considered the first monoclonal antibody to selectively target the p19 subunit of IL-23, which sets it apart from older IL-23 and IL-12/23 inhibitors.
Before Tremfya, Stelara was the first biologic to target IL-23, but it also blocked IL-12 by binding to their shared p40 subunit. Tremfya was the first biologic to exclusively target IL-23 by binding to its p19 subunit, which is more specific to psoriasis-related inflammation.
Is Tremfya effective for Psoriasis?
A study in real-world settings looked at people with mild, moderate, and severe psoriasis in the US and Canada who started Tremfya treatment between July 2017 and July 2019. After 9-12 months of Tremfya treatment:
-
- 64.6% had minimal or no psoriasis, while 36.2% had completely clear skin
- 61.5% achieved PASI 75 (75% improvement in psoriasis severity)
- Nearly 37% had completely clear skin (PASI 100)
In another study, researchers examined patients who previously failed anti-IL-17 treatments (like Cosentyx or Taltz). At 16 weeks:
-
- 60.7% achieved PASI 90 (90% improvement in psoriasis severity)
- 37.7% achieved PASI 100 (completely clear skin)
At 2 years (104 weeks):
-
- 73.8% had PASI 90
- 59.0% had PASI 100
Hard-to-treat areas like the scalp, palms/soles, fingernails, and genitals also improved by week 28. Only one patient (1.6%) had primary treatment failure (Tremfya did not work at all), and no severe side effects were reported.
7. Skyrizi
Active Ingredients: Risankizumab-rzaa
Drug Class: Interleukin-23 Antagonist
Dosage Form and Strength:
- Prefilled Syringe: 90 mg and 150 mg
- Prefilled Pen: 150 mg
Dosage Frequency for Psoriasis: Initial dose given at weeks 0 and 4, followed by a maintenance dose every 12 weeks thereafter.
Common Side Effects: Upper respiratory infections, headache, fatigue, injection site reactions, and tinea infections.
Approved Indications:
- Psoriatic Arthritis
- Plaque Psoriasis
- Crohn’s Disease
- Ulcerative Colitis
PROS:
CONS:
How does Skyrizi work for Psoriasis?
Skyrizi (risankizumab-rzaa) is among the newer medicines for plaque psoriasis. It works by targeting interleukin-23 (IL-23), similar to how Tremfya works. By blocking IL-23, Skyrizi helps reduce excessive skin cell growth and inflammation, leading to clearer skin and long-lasting symptom relief.
Is Skyrizi effective for Psoriasis?
Researchers analyzed past medical records of patients with very severe plaque psoriasis who were treated with Skyrizi. The results showed that Skyrizi is highly effective. By week 40, all patients (100%) achieved PASI 75, meaning a 75% improvement in psoriasis severity. By week 104, all patients (100%) reached PASI 90, showing a 90% improvement.
Another study examined Skyrizi’s effectiveness for plaque psoriasis in difficult-to-treat areas, including the scalp, palms, soles, nails, and genital region. These areas are often resistant to treatment.
After one year, most patients achieved clear or almost clear skin based on the Physician’s Global Assessment (PGA).
| Affected Area | Percentage of Patients Achieving PGA 0 or 1 (Clear/Almost Clear) |
|---|---|
| Scalp | 97.58% |
| Palms/Soles | 95.28% |
| Genitals | 100% (All patients cleared) |
| Nails | 82% |
In terms of drug survival rate, a real-world study found that 90.73% of patients were still using Skyrizi after three years. This suggests high patient satisfaction and tolerability. The study also showed that all patients (100%) had clear or almost clear skin in hard-to-treat areas after three years.
Summary
Each FDA-approved injection for psoriasis has its strengths and trade-offs. Humira and Enbrel, as TNF blockers, are well-established but come with a higher infection risk. Stelara, Cosentyx, and Taltz target interleukins, offering better skin clearance with less frequent dosing.
Newer IL-23 inhibitors like Tremfya and Skyrizi require fewer injections and show long-term effectiveness, but their long-term safety is still being studied.
Choosing the right treatment depends on its dosing schedule, effectiveness, and potential side effects. Each option has pros and cons, so discussing it with your doctor is the best way to decide.
Frequently Asked Questions
Related Articles
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