Treatment Options for Psoriatic Arthritis

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Psoriatic arthritis is a type of chronic inflammatory arthritis that mostly affects those who have psoriasis. It is possible however for someone without psoriasis to develop psoriatic arthritis if they have relatives with the disease. There is no cure for this type of arthritis but there are treatments that may reduce the pain and flare ups. Here are the most common psoriatic arthritis treatment options.

Nonsteroidal Anti-Inflammatory Drugs

Nonsteroidal anti-inflammatory drugs, also called NSAIDs, are drugs available in both over-the-counter strength and prescription strengths. The most common over-the-counter NSAIDs are ibuprofen (Advil and Motrin), naproxen (Aleve) and Aspirin. There are many more prescription NSAIDs available. These medications work by reducing pain and inflammation in the joints. Most people tolerate NSAIDs well, but they may cause side effects, such as nausea, and it is usually recommended that they be taken with food.

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Disease-Modifying Antirheumatic Drugs

Disease-modifying antirheumatic drugs, also called DMARDs, may be used to treat different types of arthritis, including psoriatic arthritis. Like NSAIDs, DMARDs help reduce inflammation in the joints, but unlike NSAIDs, these medications have the potential of slowing down or stopping further damage in the joints. The most commonly known DMARDs include methotrexate, hydroxychloroquine (Plaquenil) and sulfasalazine (Azulfidine). Disease-modifying antirheumatic drugs may be taken by mouth or by injection, depending on the medication. The most common side effects include diarrhea, nausea, mouth sores and fatigue.

Immunosuppressants

People with psoriatic arthritis have an overactive immune system. Immunosuppressants help to slow down your immune system’s activity, which relieves the symptoms. One of the most serious side effects to immunosupressing drugs is that your body is less able to fight infections. The most common immunosuppressants used for psoriatic arthritis pain management include azathioprine (Imuran, Azasan) and cyclosporine (Gengraf, Neoral, Sandimmune).

Corticosteroid Injections

Corticosteroid injections, also called glucocorticoids, are medications injected directly into the painful joints. The medications work on reducing inflammation directly at the source, relieving pain. Side effects are not common but they do include pain at the injection site and infection in the joint.

Immunotherapy or Biologics

A newer class of medications called immunotherapy or biologics are a subset of DMARDs, but they are more specific. Biologics, produced by living organizims, target the specific proteins causing the inflammation and pain of psoriatic arthritis. Generally given by injection or intravenous, the most common biologics used for psoriatic arthritis treatment include ustekinumab (Stelara), secukinumab (Cosentyx) and ixekizumab (Taltz). An oral biologic, tofacitinib (Xeljanz), has also received FDA approval. Like immunosuppressants, immunotherapy drugs can lower your resistance to infections.

Lifestyle Changes

If you are living with psoriatic arthritis, you may find some lifestyle changes can make your treatment more effective. This includes exercising to help your joints stay as flexible as possible, losing weight if needed to reduce stress on the joints, eating a healthy diet, limiting alcohol consumption and not smoking cigarettes.

Psoriatic arthritis is a chronic condition but with medications and lifestyle management, you can reduce joint pain and live your life to the fullest.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Feb 11
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