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Treatment Options for Moderate to Severe Psoriatic Arthritis

Medically reviewed by Debra Sullivan, PhD, MSN, RN, CNE, COI on February 2, 2017Written by Robin Madell on November 7, 2013

A painful condition

Psoriatic arthritis is a painful type of arthritis that leads to joint pain, swelling, and stiffness. If you have psoriasis, it is possible that you may also develop psoriatic arthritis. Around 30 percent of psoriasis sufferers develop both conditions.

If you have this condition, treating it early on can be the key to help soothe pain and prevent joint damage down the road.

Why treat?

Psoriatic arthritis has no known cure. However, while the condition can’t be cured, it can be effectively treated.

The goal of any type of treatment for moderate to severe psoriatic arthritis is to help you better manage difficult symptoms. Medications and lifestyle changes can treat your pain, swelling, and joint damage. Your doctor can help you select from a number of potentially effective treatment options to choose what’s best for you.

Medications may help

There are several different types of drugs that can effectively treat psoriatic arthritis. Certain over-the-counter (OTC) medicines, such as ibuprofen, can help reduce your condition’s symptoms.

If OTC drugs don’t help your joint pain and swelling, then your doctor may need to prescribe stronger medications. These include disease-modifying anti-rheumatic drugs (DMARDs), immunosuppressants, and tumor necrosis factor-alpha (TNF-alpha) inhibitors.

OTC options

One of the first treatments that your doctor may recommend is an OTC medicine. A category of drugs called NSAIDs (nonsteroidal anti-inflammatory drugs) is commonly used to treat the pain and inflammation that psoriatic arthritis causes.

Some popular OTC NSAIDs are:

  • Ibuprofen (brand names include Motrin and Advil)
  • Naproxen (brand names include Anaprox and Aleve)

NSAIDs are also available in prescription form that are more potent than OTC versions.

DMARD decisions

Your doctor may prescribe a DMARD to help slow potential joint damage caused by psoriatic arthritis. DMARDs take much longer to take effect than NSAIDs. They also may cause more serious side effects related to the lungs and kidneys, according to the Mayo Clinic.

Some types of anti-rheumatic drugs used to treat psoriatic arthritis include:

These drugs may be used alone or in combination with each other, depending on your doctor’s recommendations.

Immunosuppressant drugs

Immunosuppressants help with immune system suppression for people with psoriatic arthritis. A frequently used immunosuppressant is azathioprine.

However, immunosuppressants must be taken with extreme caution under the direction of a physician because of their risk of side effects. These drugs can cause anemia, infection, and liver and kidney dysfunction. They are generally only prescribed for very serious cases of psoriatic arthritis.

TNF-alpha inhibitors

A more recent entrant to the list of available medications to treat psoriatic arthritis is TNF-alpha inhibitors. Also sometimes called anti-TNF agents, these medications can help with psoriasis symptoms along with the symptoms of psoriatic arthritis.

Anti-TNF agents are generally used only for more severe cases of psoriatic arthritis, as they can cause serious side effects.

Some commonly prescribed TNF-alpha inhibitors include:

  • Adalimumab
  • Etanercept
  • Golimumab
  • Infliximab

Home treatments

Lifestyle changes can also make a difference in the pain and progression of psoriatic arthritis. Your doctor may suggest heat or cold treatments to help protect your joints and to ease your symptoms.

A simple ice pack or heating pad can help dull or relieve pain. The Mayo Clinic suggests using a cold pack for up to a half-hour per session one or more times a day to create a numbing effect. Use heat to relax tense muscles caused by the condition. While these treatments may provide temporary relief, they are generally recommended to those with less severe cases of psoriatic arthritis.

Don’t strain

Overdoing certain tasks like lifting, pushing, or twisting can affect your joints. Be sure to pace yourself, rest often, and take precautions when carrying out your daily tasks.

Not overdoing it applies to your diet as well. Being overweight can strain your joints, which might worsen your psoriatic arthritis. In addition to any drug treatments that your doctor may recommend, eating a healthy, low-fat diet and getting regular physical exercise can help prevent the joint pain caused by psoriatic arthritis.

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