What is the Right Treatment for PsA?

Types of Treatments

If the disease is mild, you may initially require only a nonsteroidal anti-inflammatory drug (NSAID), such as over-the-counter ibuprofen or naproxen. [2] [9] Other stronger NSAIDs are available by prescription. [10] Serious side effects could include stomach irritation or upset, heart problems, and liver and kidney damage. [10]

If your disease is more advanced or doesn’t respond to NSAIDs, disease-modifying anti-rheumatic drugs (DMARDs) may be prescribed. [2] [9] These treatments try to slow or stop disease progression either by suppressing the entire immune system or by targeting specific parts of the immune system that lead to inflammation and disease. [6] They may be taken alone or in combination, and by mouth or through injection or infusion. You can find out more about these medications here.

When PsA is more advanced, or NSAIDs and conventional DMARDs are no longer effective, your physician may prescribe biologics or biosimilars. [2] [9] These include tumor necrosis factor-alpha inhibitors, interleukin inhibitors, phosphodiesterase-4 inhibitors, and janus kinase inhibitors, each of which targets a different pathway of the immune system to reduce inflammation and limit disease progression. [2] [3] [6]

Biologics and biosimilars may be taken by mouth or given through injection or infusion. You can find an up-to-date list of available biologics at psoriasis.org, where you can also find more information on biosimilars, which may become available in the United States within a couple of years. Side effects can vary and may include infection due to immune suppression. [10] [11] Your rheumatologist will discuss the risks specific to each therapy and the ways in which you will be monitored.

Depending on the treatments – some of which require more detailed monitoring – patients generally follow up with a rheumatologist every three months, Dr. Kavanaugh says.

Other Procedures and Nondrug Treatments

In addition to these drug-based therapies, Dr. Kavanaugh says he suggests nondrug alternatives, such as physical and occupational therapy, weight loss, and general healthy living. Physical and occupational therapy can ease joint pain and help to extend range of motion. [2] Lifestyle modifications that may also help to minimize symptoms include exercising regularly, limiting alcohol consumption, and stopping smoking. [12] [13]

Depending on the extent of the disease, steroid injections can help to reduce joint inflammation. [2] [10] For patients with more severe joint damage, joint replacement surgery may be an option. [10]

It’s important to work with a rheumatologist, who can help you identify the right treatment plan for your particular symptoms. [1] [4] For help finding a rheumatologist near you, contact the National Psoriasis Foundation Patient Navigation Center.