Psoriatic Arthritis Treatments
Learn more about what treatment for psoriatic arthritis is best for you.
Psoriatic arthritis treatments primarily help relieve pain and inflammation from the condition. There are also medications for mild to moderate cases that help slow the progression of psoriatic arthritis and preserve your quality of life.
Treating Mild Psoriatic Arthritis
Non-steroidal anti-inflammatory drugs (NSAIDs) and other pain relievers are your main treatments for psoriatic arthritis. Your doctor may also send you to a physical therapist who can teach you exercises and activities to help manage the pain and inflammation from psoriatic arthritis.
If you have psoriatic arthritis in a few joints, your doctor may recommend injecting them with a steroid, which is a powerful anti-inflammatory.
While medication and steroid injections will dramatically reduce your pain, swelling, and inflammation, they are only treating psoriatic arthritis, not curing it. Even in mild cases, patients may still experience some joint wear and damage.
Treating Moderate to Severe Psoriatic Arthritis
Moderate to severe psoriatic arthritis patients may need disease-modifying anti-rheumatic drugs (DMARDs) to slow the rapid joint damage from psoriatic arthritis. Methotrexate, hydroxychloroquine, leflunomide, and sulfasalazine are common DMARDs. Doctors have prescribed DMARDs for decades with reasonable success in the treatment of psoriatic arthritis.
Tumor necrosis factor (TNF) blocker medications are a newer class of inflammation-fighting drugs that the US Food and Drug Administration (FDA) has approved for treating psoriatic arthritis. Adalimumab (Humira), golimumab (Simponi), etanercept (Enbrel), and infliximab (Remicade) are examples of TNF blockers.
New Treatments for Psoriatic Arthritis
New treatment are emerging that may really impact psoriatic arthritis. One new orally taken drug approved by the FDA is Apremilast, marketed as Otezla. This agent has been referred to as a “small-molecule” drug because it targets specific molecules within your immune cells, something that couldn’t be achieved with earlier forms of oral DMARD medications for psoriatic arthritis. New oral treatments like Otezla will purposefully stop the cellular enzyme phosphodiesterase 4, or PDE4, which controls the inflammation process of your cells. This can quell the overactive immune response that causes psoriatic arthritis’s characteristic joint inflammation. You’ll then have reduced swelling and tenderness in your affected joints.
Another newly approved agent is ustekinumab (Stelera), which has been shown in clinical trials to be very effective in the treatment of psoriasis and psoriatic arthritis. According to the FDA, Ustekinumab contains an antibody that blocks the action of two proteins (interleukin 12 and 23) that contribute to the inflammation and the overproduction of skin cells. By targeting these proteins, ustekinumab can interrupt the inflammatory pathway of psoriasis. This agent is given once every 3 months via subcutaneous injection.
The latest drug approved is secukinumab (Cosentyx), which has been shown to be effective agains psoriasis, plaqu psoriasis, and ankylosing spondylitis.
Speak to your doctor if you are interested in trying these newer treatment option.
You should always make sure your doctor is aware of what medications you are taking before you add another one.
Surgery for Joints Damaged by Psoriatic Arthritis
If you have a moderate to severe case of psoriatic arthritis, your joints wear out to the point where they are constantly painful or fail to function. In some cases, such as when your joint pain wakes you up at night, surgery may be your best option to help relieve your misery.
Complete replacements of the hip, knee, and hand joints have been effective for decades and have an exceptional success rate. Shoulder and ankle joint replacement is also an option, although the satisfaction rates are not as high.
Fusion surgery can be helpful in select situations. Fusions are still the standard for treating spine arthritis (spondylitis) and for repairing toe, foot, and angle joints. Surgeons fuse joints by first removing ligament, bone cartilage, and other tissue that has not been destroyed by arthritis or an injury.
They subsequently use metallic hardware to join two or more bones together. Some patients complain that fusions reduce the motion in the joint dramatically. Nevertheless, they often report dramatic reductions in pain, and generally agree that losing the motion is worth the improvement in quality of life. Talk to your doctor if your psoriatic arthritis produces pain, swelling, or other discomfort. While NSAIDs and other pain medications are usually effective, there are numerous treatments if you need more relief. Most people living can enjoy a life free from constant psoriatic arthritis symptoms.