Wednesday 15 March 2023

A guide to psoriatic arthritis medication


Medications can relieve symptoms such as joint pain, stiffness, and swelling for people with psoriatic arthritis. The right drugs can also slow disease progression and prevent or limit permanent joint damage.

Psoriatic arthritis (PsA) is an autoimmune condition where the immune system attacks the joints and causes inflammation and tissue damage.

Treatments for PsA may include pain relievers, drugs that fight inflammation, and long term medications that calm the immune system’s attack on the joints. Treatments include:

  • nonsteroidal anti-inflammatory drugs (NSAIDs)
  • corticosteroids
  • disease modifying antirheumatic drugs (DMARDs)
  • biologics
  • small molecule medications

No single treatment works for everyone, so a person with PsA will work with their medical provider to find the right medication or therapy.

This article looks at the long and short term medications that can help treat PsA, along with the latest advances in treatments.

How they work

Side effects

NSAIDs are safe for most people if they take them under a doctor’s directions and only for a short time. But people who take NSAIDs for extended periods may experience side effects that can be serious.

Risks of using NSAIDs include:

  • skin reactions, such as reddening or blisters
  • allergic reaction, such as hives, itching, wheezing, swelling, or a rash
  • stomach bleeding or bleeding in the digestive tract
  • heart attack or stroke, though aspirin does not increase this risk

The Food and Drug Administration (FDA)Trusted Source say people should take NSAIDs at the lowest effective dose for the shortest amount of time to reduce the risk of dangerous side effects.

In summary, NSAIDs are not suitable for long term use. NSAIDs are helpful for occasional pain and stiffness, but not as a continual therapy for PsA.

How they work

Side effects

How they work

Types and side effects

The most common DMARDs for PsA are:

  • methotrexate (Rheumatrex, Trexall)
  • sulfasalazine (Azulfidine)
  • leflunomide (Arava)
  • cyclosporine (Gengraf, Neural, Sandimmune)
  • hydroxychloroquine (Plaquenil)

Methotrexate

Methotrexate is an immunosuppressive drug that treats psoriasis. It also works well for PsA and can help prevent damage to joints. Rarely, methotrexate can cause liver damage, so a person will need to see their doctor regularly for tests.

Sulfasalazine

Sulfasalazine is a type of sulfa drug that has powerful anti-inflammatory effects. People who are allergic to sulfa drugs cannot take it. It helps prevent joint swelling, inflammation, and damage that PsA causes.

Leflunomide

Although this is a rheumatoid arthritis drug, some doctors prescribe it for PsA. It may cause diarrhea in up to 20 percent of people.

Cyclosporine

Cyclosporine is an immunosuppressant that helps treat autoimmune conditions. Side effects include high blood pressure, headache, and stomach pain.

Antimalarial treatment

Certain drugs that treat malaria can help with PsA. Results may take several months, however. Side effects include headaches, dizziness, nausea, vomiting, and vision changes.

Acthar

Acthar is an injectable medication that can help the body make its own steroid hormones, which helps lower inflammation. Acthar is useful for fast relief of severe inflammation and swelling.

Azathioprine

Azathioprine (Imuran) is a drug that suppresses the immune system, which helps with both PsA and skin psoriasis.

How they work

Types

Side effects

Types

Side effects

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