Psoriatic Arthritis Medications
NSAIDs, DMARDs, and Other Medications for Psoriatic Arthritis
Currently, there’s no cure for psoriatic arthritis, but some medications can significantly help control psoriatic arthritis symptoms such as joint pain and inflammation.
Some psoriatic arthritis medications can actually help to prevent psoriatic arthritis from worsening, and they can also help you maintain your quality of life.
Below are common medications used to treat psoriatic arthritis.
Before trying any new medications for psoriatic arthritis, have a conversation with your doctor. The medications listed in this article may have side effects or interact with other medications or supplements you’re taking, so be sure you let your doctor know everything you’re taking.
Non-steroidal anti-inflammatory drugs (NSAIDs): Over-the-counter NSAIDS are frequently the first line of treatment for psoriatic arthritis, and they’re also used for mild psoriatic arthritis cases. Ibuprofen (eg, Motrin) and naproxen (eg, Aleve) are examples of NSAIDs you can take without a prescription.
If over-the-counter NSAIDs don’t work, your doctor may want you to try a prescription-strength NSAID, such as Celecoxib (eg, Celebrex).
Disease-modifying anti-rheumatic drugs (DMARDs): These powerful medications are typically reserved for more moderate to severe cases of psoriatic arthritis. They work by actually preventing the disease from worsening as well as modifying the psoriatic arthritis by preventing joint damage—not just pain and inflammation,
However, DMARDs act very slowly, so you may not notice the effects of the medication for a few weeks.
Methotrexate (eg, Trexall), leflunomide (eg, Arava), and sulfasalazine (eg, Azulfidine) are all examples of common DMARDs used to treat psoriatic arthritis.
Immunosuppressant medications: Immunosuppressants help treat more severe forms of psoriatic arthritis. They work by suppressing your immune system. Your immune system normally protects your body from bacteria and viruses, but when you have psoriatic arthritis, the immune system can become over-active and attack healthy tissue. Immunosuppressants work by calming down the immune system.
Commonly used immunosuppressants for psoriatic arthritis are azathioprine (eg, Imuran), cyclosporine (eg, Sandimmune), and leflunomide (eg, Arava).
TNF-alpha inhibitors: Tumor necrosis factor (TNF)-alpha inhibitors are typically used for severe cases of psoriatic arthritis. They’re a newer class of DMARDs that help block inflammatory proteins called cytokines.
TNF-alpha inhibitors can be used if traditional DMARDs don’t work. They can also be taken alone but are commonly used with other DMARDs. These medications are incredibly potent, so your doctor will carefully monitor you while taking them.
Adalimumab (eg, Humira), etanercept (eg, Enbrel), and infliximab (eg, Remicade) are examples of TNF-alpha inhibitors.
Newer Agents (non-TNF-biologics): The FDA recently approved three new agents that a target different mechanisms of action. These include ustekinumab (Stelera), which is an interleukin 12 and 23 inhibitor, apremilast (Otezla) an oral agent that inhibits the enzyme phosphodiesterase 4, and secukinumab (Cosentyx) that targets interleukin 17.
Corticosteroids: If oral medications don’t work for you, your doctor may recommend a type of corticosteroid called injectable steroids. They can significantly reduce inflammation. For severe cases of psoriatic arthritis, your doctor may also recommend steroids instead of trying other medications first.
Because everyone is different, your doctor will let you know how many injections you’ll need to get the benefits of corticosteroids.
Dexamethasone (eg, Decadron) is an example of a corticosteroid used to treat psoriatic arthritis.
Which Psoriatic Arthritis Medication Is Right for You?
Your doctor will let you know which medication—or combination of medications—is right for you. Keep in mind that although medications for psoriatic arthritis can help to dramatically decrease your joint pain and other psoriatic arthritis symptoms, they’re not a cure.