Traditional Systemic Drugs
Cyclosporine is an immunosuppressive drug that is FDA-approved for treating psoriasis, and it may produce improvement in psoriatic arthritis. Periodic blood tests are required due to the possibility of kidney damage.
Methotrexate, an immunosuppressive drug, is FDA-approved for treating psoriasis, and is used widely and successfully for treating psoriatic arthritis and rheumatoid arthritis. It can be effective at relieving the symptoms associated with psoriatic arthritis, and it may help prevent joint destruction.
Methotrexate usually is well tolerated in low doses. However, it potentially has a number of side effects and the long-term potential of damaging the liver. With careful management and dosage, the drug can be used safely for years by certain individuals. A person taking methotrexate should follow a doctor's instructions carefully.
Acitretin (also know by its brand name Soriatane), a systemic retinoid FDA-approved for severe skin psoriasis , may be effective for some people with psoriatic arthritis. Oral retinoids carry the risk of birth defects in women of child-bearing potential, and the rare possibility of producing skeletal side effects with long-term use.
Sulfasalazine, a sulfa drug developed to treat inflammatory bowel diseases, is sometimes used for psoriatic arthritis. Approximately one-third of psoriatic arthritis patients respond rapidly to this treatment (usually within four to eight weeks).
Sulfasalazine is given in doses of 4 tablets twice a day. Use of sulfasalazine is not recommended in patients with sulfa allergies, people with intestinal or urinary obstructions and individuals suffering from porphyria, a metabolism disease. A doctor may require regular blood tests while a patient is on sulfasalazine to monitor cell counts and liver enzymes. Possible side effects include nausea, rash, headache, abdominal pain, vomiting, fever and dizziness.