Psoriatic Arthritis: Symptoms, Diagnosis, and Treatment

Treatment of psoriatic arthritis focuses on:  

• Stopping progression of the disease. 
• Reducing inflammation.  
• Treating skin symptoms. 
• Relieving pain.  
• Keeping joints as mobile as possible. 

Early, aggressive treatment of PsA helps to minimize the effect of the disease on your quality of life. Managing psoriatic arthritis can seem like treating two diseases.  Since many people with PsA have psoriasis, they may see a primary care doctor, a dermatologist and a rheumatologist. Some treatments work on both diseases. Others work mainly or only on skin problems or arthritis. All medications have benefits and risks. 

Treating Psoriasis  
The over-the-counter (OTC) and prescription treatments for psoriasis include:  

• Topical medications made from vitamin D, derivatives of vitamin A, salicylic acid, coal tar or corticosteroids.  
• Treatments using sunlight or specialized ultraviolet light. 
• Medicines that target the skin. 
• Medicines that target the immune system. 

Treating Psoriatic Arthritis
The over-the-counter (OTC) and prescription medicines for psoriatic arthritis include:  

NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) are usually taken by mouth, although some can be applied to the skin. Popular over-the-counter (OTC) versions, such as ibuprofen and naproxen sodium, help to ease pain.  Many prescription NSAIDs can help reduce inflammation, too.  

Corticosteroids. These powerful anti-inflammatory medicines can be taken by mouth (orally) or injected into a joint at a doctor’s office. In the case of oral corticosteroids, doctors try to use these drugs at the lowest dose for the shortest time possible because of side effects, which can include facial swelling, easy bruising, weight gain and weak bones.  

DMARDs. Disease-modifying antirheumatic drugs (DMARDs) are powerful medications that reduce inflammation and can stop PsA from getting worse. They are available as pills, can be self-injected or given as an infusion. There are three types of DMARDs: 

• Traditional DMARDs have been used the longest and have a broad immune-suppressing effect. The most commonly-used drug is methotrexate. These medicines are usually taken by mouth and can take up to three months to become fully effective. 
• Biologics interrupt certain chemicals or steps in the inflammatory process and they generally work more quickly than traditional DMARDs. They are self-injected or given by infusion in a doctor’s office. 
• Targeted DMARDs, like biologics and Janus kinase (JAK) inhibitors, also block certain steps in the inflammatory process, but these drugs are taken by mouth. 

While DMARDs can be very effective, in many cases they suppress the immune system and raise the risk of infection.  

Every person with PsA is different. Doctors recommend certain medications depending on: 

• How many and which parts of the body are affected. 
• How severe the disease is. 
• How many joints are affected. 
• Drug allergies and other health conditions. 
• Current medication use.