Treatment. Psoriatic Arthritis

Psoriatic arthritis treatment

There is no cure for psoriatic arthritis. The goal of psoriatic arthritis treatment is to control inflammation in the affected joints so that disability and pain can be prevented.

Medications for psoriatic arthritis

There are several different classifications of medications used for psoriatic arthritis treatment. They include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): These drugs help to reduce both pain and inflammation. Non-prescription NSAIDs include naproxen (Aleve) and ibuprofen (Motrin IB, Advil, and others). Prescription-strength NSAIDs are also available. Side effects of nonsteroidal anti-inflammatory drugs include kidney and liver damage, bleeding, and stomach irritation.
• Disease-modifying anti-rheumatic drugs (DMARDs): These medications for psoriatic arthritis can help prevent permanent damage to joints and other tissues by slowing the progression of disease. Some common DMARDs include leflunomide (Arava), methotrexate (Trexall), and sulfasalazine (Azulfidine). However, these drugs have the potential to cause severe side effects, which include infections of the lungs, bone marrow suppression, and liver damage. 
• Immunosuppressants: These drugs suppress the body’s immune system and stop the attack on the tissues and joints. However, since they work by decreasing the immune response, they also make the patient more susceptible to infection. These medications include cyclosporine (Sandimmune, Neoral, Gengraf) and azathioprine (Imuran, Azasan). 
• TNF-alpha inhibitors: Tumor necrosis factor-alpha (TNF-alpha) is an inflammatory substance produced by the body. These medications help block inflammation which reduces swelling and pain in the joints and helps increase joint mobility. Examples of these medications are etanercept (Enbrel), adalimumab (Humira), golimumab (Simponi), infliximab (Remicade), and certolizumab (Cimzia). Potential side effects of these drugs include diarrhea, hair loss, nausea, and an increased risk for severe infections. 

Psoriatic arthritis surgery and other procedures

• Corticosteroid injections: Steroids are sometimes injected directly into the affected joints to treat psoriatic arthritis. They reduce pain and inflammation very quickly. They can also cause joint damage if given too often, so the number of injections given per year or six months may be limited. 
• Joint replacement surgery: When joints have been severely damaged, psoriatic arthritis surgery to replace them may become necessary. Hips and knees are the joints most often replaced. The joints are removed and are replaced with implants made of plastic and metal.  

Outcome & Complications

Most of the time, psoriatic arthritis alternates between periods of improvement and flare-ups. However, sometimes the disease can lead to severe disability due to joint damage. In addition, a small percentage of people with the disease develop a condition called arthritis mutilans, which is a very severe, disabling, and painful form of psoriatic arthritis. This form of disease mainly affects the joints of the toes that are closest to the nail and the joints of the fingers. It eventually results in a loss of function. The condition is also frequently associated with neck and lower back pain.