Learning you have psoriatic arthritis can be an uneasy and confusing time. You may not have known much about it or even heard of it until faced with the diagnosis. But although there isn't yet a cure, the good news is that many effective treatment options are available. These treatments not only help reduce arthritis symptoms like joint pain and stiffness, they also work to help slow, or even stop, progression of the disease.
Here are a few things you should know about treating psoriatic arthritis.
Don't delay treatment.
It's important to talk with your doctor about treatment options as soon as you're diagnosed with psoriatic arthritis. This may be true even if your symptoms are mild. Why? Early treatment can actually help prevent your condition from getting worse or slow its progress by reducing the inflammation that can cause joint damage.
Understand your medication options.
Medication is the primary way to treat psoriatic arthritis. However, there isn't a one-size-fits-all treatment plan for this disease. Your doctor will develop a personalized plan based on your specific condition and health needs. Below are three common medication options:
1. Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs, such as ibuprofen (Advil or Motrin) and naproxen (Aleve), are typically the first method of treatment for psoriatic arthritis. NSAIDs come in both over-the-counter and prescription strengths and have been shown to reduce pain and swelling as well as improve joint motion for many people with psoriatic arthritis. Your doctor will adjust a NSAID dosage that offers you maximum relief.
Be sure to check with your doctor before taking NSAIDs regularly. Depending on your health situation, some types of NSAIDS may be better for you than others. For example, COX-2 inhibitors such as celecoxib (Celebrex) are newer NSAIDs that may cause fewer side effects in people prone to stomach problems. However, COX-2 inhibitors are also much more expensive than traditional NSAIDs and may increase the risk of heart attacks.
2. Disease-modifying antirheumatic drugs (DMARDs)
If your arthritis does not respond well to NSAIDs or if you show signs of joint damage, your doctor may prescribe a DMARD. These drugs work by suppressing the overactive immune system function that creates inflammation and leads to psoriatic arthritis symptoms.
There are many drugs considered DMARDs. The most common include systemic or "traditional" DMARDs and biologic response modifier drugs (biologics).
Examples of these drugs include acitretin (Soriatane), cyclosporine (Neoral and Sandimmune), leflunomide (Arava), methotrexate (Rheumatrex), and sulfasalazine (Azulfidine), some of which have been used for decades to treat psoriatic arthritis.
These "traditional" DMARDs can help slow progression of the disease. However, many systemic drugs pose potential risk for liver or kidney damage with long-term use, and patients must be monitored closely.
Biologic drugs, which are made from human or animal protein molecules, have been shown to slow the progression of joint damage by targeting specific cells that cause inflammation. They can also dramatically reduce painful psoriatic arthritis symptoms. Common biologics used for psoriatic arthritis include adalimumab (Humira), etanercept (Enbrel), and infliximab (Remicade).
Unfortunately, biologics are expensive. As a result, insurance companies may require patients try a "traditional" DMARD before approving payment for biologics.
3. Corticosteroid injections
Corticosteroid shots can temporarily relieve severely swollen joints in many people with psoriatic arthritis. However, they are not recommended for long-term therapy and do not reduce damage to the joints.
Focus on quality of life.
There are many things you can do to help reduce psoriatic arthritis symptoms and live a full, more active life. For example, using ice packs on joints during an arthritis flare-up can help reduce pain and swelling. Participating in regular exercise can maintain strength and range of motion in your joints. And, if joint damage is severe, surgery to repair or replace the joint can improve joint function and your quality of life.