Psoriatic arthritis: Is it time to change your treatment?
Psoriatic arthritis is an unpredictable and painful condition affecting the joints.
The aim of treatment for psoriatic arthritis is to slow the progression of the disease, relieve the symptoms, improve quality of life and restore functions and movement.
Regular review of treatment options with a doctor or specialist will help make sure the best approach is being taken.
As well as medication, doctors may recommend lifestyle changes to help manage the condition.
Medications used to treat psoriatic arthritis
There are a number of medications used for psoriatic arthritis treatment, including:
- Nonsteroidal anti-inflammatory drugs ( NSAIDs): These include both over-the-counter and prescription medications such as ibuprofen. They may help reduce joint pain, inflammation and stiffness.
- Disease-modifying anti-rheumatic medications (DMARDs): These drugs target the immune system and slow the progression of psoriatic arthritis. They are more powerful than NSAIDs but take longer to work. Among the DMARDs used for psoriatic arthritis treatment are methotrexate and sulfasalazine.
- Biologicals - The newest tools for treating psoriasis and psoriatic arthritis are biologic medications that include etanercept, infliximab, and adalimumab. Biologic medications work by targeting the immune system response that causes the symptoms of psoriatic arthritis, preventing the joints from becoming inflamed. Biological medications may also make the immune system more susceptible to infections.
- Corticosteroids: Steroids can help reduce severe inflammation. They can be taken either by mouth or by injection. (These steroids act differently than anabolic steroids, which are used to build muscle.)
10 signs your psoriatic arthritis treatment may need changing
- You're having excessive or dangerous drug side effects. While many of the medicines used to treat psoriatic arthritis have given people their lives back and prevented permanent joint damage, they are not without risks. For instance, NSAIDs increase the risk of stomach irritation and bleeding, methotrexate can damage the liver, and some biological therapies carry a risk of serious infection. If you experience side effects from your medication, talk to your doctor about other treatment options.
- Your psoriatic arthritis symptoms are interfering with your career or daily life. That can mean different things for different people. If you're a university professor and your treatment gets rid of all your symptoms except two swollen finger joints, you might be able to cope. But if you're a concert violinist who relies on those joints for a living, you might need to reduce those symptoms with a stronger medication. Being open with your doctor about your lifestyle and career can help guide your psoriatic arthritis treatment.
- You're not feeling any better. Given the range of treatments for psoriatic arthritis, most people should be able to get some degree of relief. If your psoriatic arthritis symptoms don't improve, or get worse, talk to your doctor about other options.
- You're feeling a lot of fatigue. While fatigue is a very common side effect of psoriatic arthritis, it is also a side effect of many medications used for psoriatic arthritis treatment. Psoriatic arthritis may also cause anaemia, which causes fatigue. If you're feeling more tired than usual, ask your doctor whether you might need to change medications or take iron supplements.
- Your skin lesions are not clearing up. If medications are improving your psoriatic arthritis symptoms but your skin lesions are still bothering you, ask your doctor whether adding a topical medication might help.
- Certain joints, especially your knees, are still swollen or painful. Your doctor may decide to use a corticosteroid injection to ease inflammation in a particular joint. If your joint is sore or swollen, ask your doctor whether physiotherapy might help.
- Several of your joints are still swollen. Even if your joints are feeling less sore, it's important to keep an eye on swelling and inflammation. Those symptoms can indicate your joints are still being damaged from psoriatic arthritis. If the swelling isn't going down after you've been taking your medication for a while, ask your doctor what else you can do to stop any additional damage.
- You have a badly damaged joint that is not improving. In some cases, psoriatic arthritis can cause extreme joint damage. If this has happened to you, your doctor may decide that you need surgery to repair the joint
- You're depressed. Psoriatic arthritis and its symptoms can affect your mood. If you are experiencing depression, ask your GP about treatment options or about getting a referral to a therapist.
- Your symptoms have gone into remission. Psoriatic arthritis symptoms tend to come and go, so you may be able to reduce your medication dose when your disease is in remission. Ask your doctor about taking a drug “holiday” if your psoriasis and psoriatic arthritis symptoms have vanished. Don't stop taking medication without seeking your doctor’s advice first.