What Is Psoriatic Arthritis? Symptoms, Causes, Diagnosis, and Treatment

Medication is the mainstay of treatment for psoriatic arthritis. Your rheumatologist will recommend which medication to try first according to the severity of your symptoms, any drugs you have tried in the past, any other drugs you’re currently taking (for psoriatic arthritis or another condition), your overall health, and your personal preferences. Some of the medications used to treat psoriatic arthritis are taken as pills, some are injections, and some are given as IV infusions.

Ideally, medications will keep psoriatic arthritis under control and surgery won’t be needed, but if it is, a few options are available, including synovectomy, joint replacement, and joint fusion.

Lifestyle measures such as getting regular exercise can also help with symptom management and improving your overall health and mood.

Medicines

Medicines used for treating psoriatic arthritis include the following:

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) NSAIDs, such as ibuprofen (Advil, Motrin) and naproxen (Aleve), can help reduce inflammation and pain. While these medicines are available over-the-counter (OTC), your doctor may be able to write you a prescription for a stronger version.
• Steroids Steroids can help reduce inflammation quickly. They can be given orally or are sometimes injected right into the problematic joint.
• Disease-Modifying Anti-Rheumatic Drugs (DMARDs) DMARDs are often recommended if your condition doesn’t improve with NSAIDS. They can help slow the progression of the disease and prevent permanent joint damage. The most commonly used DMARD is methotrexate (Trexall).
• Janus Kinase (JAK) Inhibitors JAK inhibitors are a new type of DMARD that blocks certain enzymes that can cause inflammation. They are taken as pills. JAK inhibitors approved to treat psoriatic arthritis include tofacitinib (Xeljanz) and upadacitinib (Rinvoq).
• Phosphodiesterase-4 (PDE4) Inhibitors PDE4 inhibitors are another new DMARD. They work by selectively targeting small molecules inside immune cells to correct the overactive immune response that causes inflammation in psoriatic arthritis. The drug apremilast (Otezla) is the only PDE4 inhibitor approved for psoriatic arthritis.
• Biologics Biologics target specific cells or proteins in the immune system that play a role in the development of psoriatic arthritis. They can lessen pain and improve swollen joints. Nearly a dozen biologic drugs are approved for the treatment of psoriatic arthritis.

Treatments for Psoriasis

The medications used to treat psoriatic arthritis may also control psoriasis, but if they don’t, other options include:

• Topical therapies, including creams, lotions, shampoos, gels, sprays, and ointments, are applied directly to the skin.
• Phototherapy, or light therapy, in which the skin is exposed to ultraviolet light, suppresses immune activity in the skin.
• Systemic therapies other than those used for psoriatic arthritis may be prescribed for psoriasis.

Surgery

In some cases, surgery may be needed to repair or replace joints that are severely damaged by psoriatic arthritis.

• Synovectomy is the removal of the synovium, the connective tissue that lines the insides of joints. In psoriatic arthritis, the synovium can become inflamed and overgrown, causing swelling and pain in the joint and contributing to the destruction of the cartilage.
• Joint replacement surgery involves removing the diseased joint and replacing it with an artificial prosthesis.
• Joint fusion can relieve pain and discomfort in the joint, but it also eliminates any movement in the joint. It is generally done as a last resort to control pain.

Lifestyle Approaches

Some lifestyle habits that may improve your pain and help you feel better overall include:

• Exercise. Regular physical activity can make your joints more flexible. Try walking, riding a bike, or swimming.
• Maintain a healthy weight. Being overweight can put more strain on your joints, which increases pain. Losing a few extra pounds can relieve this stress and give you more energy.
• Rest when you need to. Psoriatic arthritis, and sometimes the medicines you take to treat it, can cause extreme fatigue. While being active is important, it’s also vital to rest when you’re tired.

Clinical Trials

Researchers are always testing new therapies to help conditions like psoriatic arthritis. If you’re interested in participating in a clinical trial, visit ClinicalTrials.gov to search for studies in your area.

Learn More About Psoriatic Arthritis Treatments