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Treating Psoriatic Arthritis and Psoriasis Together: Your Options

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Treatments That Can Work for Both Psoriasis and Psoriatic Arthritis

If you have psoriasis and psoriatic arthritis, you need an individualized treatment plan based on the severity of each condition and your response to medication. According to Luk, there are a number of different drug options:

  • Nonbiologic Disease-Modifying Anti-Rheumatic Drugs (DMARDs)  Cyclosporine (Restasis), leflunomide (Arava), methotrexate (Trexall), and sulfasalazine (Azulfidine) can be used to suppress the immune system and slow down the processes that result in psoriatic arthritis and psoriasis. If the psoriatic arthritis is severe, your doctor may prescribe two DMARDs.
  • Biologic DMARDs These drugs made from living cells treat psoriasis and psoriatic arthritis by targeting key parts of the immune system involved in the inflammation process, such as the protein tumor necrosis factor alpha (TNF-alpha), and interleukins 12 and 23. These medications include ustekinumab (Stelara), an IL-12 and IL-23 inhibitor, and secukinumab (Cosyntyx), an IL-17 inhibitor.
  • JAK Inhibitors Xeljanz and Xeljanz XR (tofacitinib) can reduce inflammation from psoriatic arthritis by targeting a specific part of the immune system. Deucravacitinib (Sotyktu) is a JAK inhibitor that’s been approved to treat moderate to severe psoriasis.
  • Phosphodiesterase Inhibitors Otezla (apremilast) blocks the action of certain naturally occurring substances in the body that cause inflammation.

Other medications focus on just one condition or the other. For example, topical therapies can treat psoriasis, but they won’t help your joints. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil or Motrin) and aspirin, can ease psoriatic arthritis pain, but they won’t improve psoriasis.

Cautions About Medication

Treatment for psoriatic arthritis and psoriasis is often a balancing act because a drug that’s prescribed to calm one condition can lead to a flare of the other. Research suggests that certain NSAIDs (among other medications) may potentially increase the risk of psoriasis.

It’s long been thought that systemic corticosteroids, which can effectively treat a psoriatic arthritis flare, can cause psoriasis to flare; however, newer analyses note that the risk is low and that more data is needed.

Before deciding on a treatment plan, be sure to tell your doctor if you’re taking prescription medication for any other conditions, such as high blood pressure, high cholesterol, or diabetes, as well as if you use any over-the-counter medication or herbal remedies.

Drug interactions can be a concern with some medications used to treat psoriasis and psoriatic arthritis, and some of the medications may have bothersome side effects.

Balancing Dual Treatments

These tips can help you manage both psoriatic arthritis and psoriasis:

Get educated. The more you know about these disorders and their possible treatments, the better you can manage your symptoms. If you have any questions, ask your doctor. If you see a different doctor for each condition, be sure each doctor has the contact information for the other and request that they communicate. Try to be aware of the possible side effects of the drugs you’re taking, and if you’re concerned you’re experiencing a side effect or negative reaction, speak with the appropriate doctor at the first sign of trouble.

Stick to your treatment plan. Be sure to take all medication as directed and don’t discontinue any without talking with your doctor first, says Luk. If cost is an issue, check out the drug manufacturer’s website for financial assistance options, or ask your doctor if there’s a less expensive treatment you could try.

Speak with your pharmacist. Your pharmacist is a good resource iIf you have questions about medications, possible interactions, or would like more information about drug affordability programs.

Check in with your doctors. Know the time frame in which you should see some results after starting a new medication, and call your doctor if treatment isn’t helping, or is calming one condition but causing the other to flare. Many medications may take months to work, while biologic DMARDs may take just a few weeks to start making a difference.

There are many treatment options for both psoriatic arthritis and psoriasis, but it may take some trial and error to find the ones that work best for you.

Additional reporting by Becky Upham.

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