Psoriatic arthritis is an inflammatory type of arthritis that can occur in patients who have psoriasis, a chronic autoimmune skin condition that causes rapid skin cell growth and renewal.
There is no cure for psoriatic arthritis. The drugs used to treat psoriatic arthritis are considered to have an acceptable safety profile by the Food and Drug Administration (FDA).
Treatment depends on the patients’ symptoms and severity, and is aimed at relieving symptoms and preventing further joint damage. Talk to your doctor about the benefits and possible side effects of each drug to help figure out which is the safest drug for you.
Medications to treat pain and inflammation may be used such as:
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
Treatment for more severe cases of psoriatic arthritis may include:
- Corticosteroid injections into the joints
- Disease-modifying antirheumatic drugs (DMARDs)
- Nonbiologics
- Hydroxychloroquine (Plaquenil)
- Methotrexate (Folex, Rheumatrex, Rasuvo, Otrexup, Xatmep, Trexall)
- Sulfasalazine (Azulfidine EN-tabs, Azulfidine, Sulfazine)
- Azathioprine (Azasan)
- Apremilast (Otezla)
- Leflunomide (Arava)
- Possible side effects of nonbiologic DMARDs include:
- Biologics (antitumor necrosis factor (TNF) agents)
- Ustekinumab (Stelara)
- Abatacept (Orencia)
- Secukinumab (Cosentyx)
- Ixekizumab (Taltz)
- Tofacitinib (Xeljanz)
- Adalimumab (Humira)
- Etanercept (Enbrel)
- Golimumab (Simponi)
- Infliximab (Remicade)
- Possible side effects of biologic DMARDs include:
- Injection site redness, swelling, itching, bruising, or pain
- Sinus infection (sore throat, runny nose, hoarseness)
- Headache
- Rare side effects of both the nonbiologic DMARD methotrexate and some biologic DMARDs (including adalimumab [Humira], etanercept [Enbrel], golimumab [Simponi], and infliximab [Remicade]) include serious infections such as tuberculosis, fungal infections such as yeast, pneumonia, or food-borne illnesses such as listeria, and cancer, usually lymphoma
- The risk of serious infections or cancer is increased by taking two or more biologic DMARDs together or by taking a biologic DMARD with a nonbiologic DMARD
- Nonbiologics
- Topical treatments for psoriasis symptoms
- Retinoid and steroid creams
- Prescription vitamin D creams
- Over-the-counter or prescription salicylic acid creams, gels, and shampoos
- Immunosuppressants
- Cyclosporine (used for severe cases that do not respond to other systemic treatments)
What Are Symptoms of Psoriatic Arthritis?
Symptoms of psoriatic arthritis include:
- Skin rash (psoriasis)
- Red patches of skin with silvery scales (plaques)
- Commonly appears on the scalp, elbows, knees, and around the ears
- Skin redness and warmth
- Scaly and itchy skin
- Thickening skin
- Joint pain, swelling, and stiffness
- Often on one side of the body
- Pain is worse in the morning or after resting
- Can affect any joint, but commonly occurs in large joints of lower extremities such as the knees and ankles
- Pain and stiffness of the neck and lower back
- Back, hip, and shoulder pain
- Reduced range of motion in the joints
- Fatigue
- Heel pain and foot pain
- Sausage-like swelling of fingers and/or toes
- Nails separate from nail bed
- Pitted, crumbling nails
- Eye inflammation such as pink eye (conjunctivitis)
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https://www.niams.nih.gov/Health_Info/Psoriatic_Arthritis/default.asp
https://www.uptodate.com/contents/psoriatic-arthritis-beyond-the-basics
https://creakyjoints.org/
https://www.arthritis.org/
https://www.ncbi.nlm.nih.gov/books/NBK115127/