Treating Psoriatic Arthritis

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PHYSICIAN VOICES
4 Signs Your Psoriatic Arthritis Treatment Isn't Working

  • woman rubbing joints on hand
    Treating psoriatic arthritis can be a moving target.
    Psoriatic arthritis is a type of inflammatory arthritis associated with psoriasis, a chronic disease that affects skin and nails. My psoriatic arthritis patients may have several different symptoms that I look for at every visit. Some of the more common ones are inflammation of small and large joints of the body and scaly, red skin. Other symptoms may include lower back pain and stiffness, enthesitis (inflammation of the area where tendons and ligaments meet bones), and extreme swelling of fingers and toes (known as sausage-shaped digits). People with psoriatic arthritis may also have fatigue and problems moving around comfortably. We have more options than ever now to treat psoriatic arthritis. If your prescribed treatment is not helping eliminate or reduce your psoriatic arthritis symptoms, you need to tell your doctor. But how do you know if your treatment is working?



  • birth control pills and calendar
    1. A few months have passed, and symptoms have not improved.
    Once a medication or combination of medications is prescribed, you have to wait for the drug to reach a certain level in your system to be effective. That can take up to three months. We like to give any drug a fair trial of being active.  We ask people to be patient and wait for the medication to help reduce the pain and stiffness in their joints and clear up their skin. But do call your doctor right away if you have any questions about the treatment or experience any unpleasant side effects or increased pain. If your symptoms are still present after three months, it’s time to work with your doctor to determine the next treatment option.

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    2. Some symptoms have improved but others have not.
    There are many different types of psoriatic arthritis symptoms and it’s important for a treatment to relieve most or all of them. We consider the treatment successful only if your symptoms have either gone away completely or have been minimized. Most medications address both the joint inflammation and the psoriasis flare-ups, but some work better on skin issues and some work better on joint issues. If your joint pain and swelling is an ongoing problem and your medication is not providing relief, it’s important to tell your doctor.

  • Doctor Writing Medical Prescription
    3. Symptoms that had disappeared have returned or new symptoms are present.
    Occasionally people with psoriatic arthritis who start a treatment see an initial period of improvement, followed by a drop in the drug's effectiveness. Some drugs lose their potency over time because your body may build up antibodies that block the drug’s benefits. At that point, it’s necessary to change your treatment. Or, you may develop a new symptom or associated condition of psoriatic arthritis. New symptoms or conditions mean a new treatment plan is necessary to manage them.

  • woman with headache
    4. You’re experiencing adverse side effects or an allergic reaction.
    All of the psoriatic arthritis medications come with potential side effects, risks, and allergic reactions. For example, biologics, drugs that block proteins in the body from triggering inflammation, suppress your immune system and raise the risk of infections or certain cancers. Side effects from other drugs include headaches, upper respiratory tract infections, weight loss, and worsening depression. Some medications can also cause a variety of gastrointestinal issues such as abdominal pain, nausea, and diarrhea. Call your doctor immediately if you are experiencing any negative side effects from your treatment.

    *This article is not an endorsement of any particular drug, but rather a description of the new drugs available to patients. Please consult with your physician to decide the best treatment options.

4 Signs Your Psoriatic Arthritis Treatment Isn't Working

About The Author

Dr. Ana-Maria Orbai, MHS, is a rheumatologist at Johns Hopkins Arthritis Center. Her focus at the Center is in psoriatic arthritis and spondyloarthritis care.
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THIS CONTENT DOES NOT PROVIDE MEDICAL ADVICE. This content is provided for informational purposes and reflects the opinions of the author. It is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare professional regarding your health. If you think you may have a medical emergency, contact your doctor immediately or call 911.
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