How to treat psoriatic arthritis

How to treat psoriatic arthritis

There are a lot of treatments available for psoriatic arthritis (PsA), so it may feel a bit overwhelming to think about them all.1 If you also have psoriasis (PsO), you may also need treatment for skin lesions.2 Different treatments work in different ways and are suitable for different situations,3 so it’s important to work with your healthcare professional to find what’s right for you.

Find out more about what's out there for PsA, and for PsO:

Nonsteroidal anti-inflammatory drugs (NSAIDs)4,5

NSAIDs are a large group of anti-inflammatory drugs that can be gotten over-the-counter or through a prescription from your doctor.

Disease-modifying antirheumatic drugs (DMARDs)4

Conventional synthetic DMARDs slow or prevent inflammation that damages joints and skin. A biologic may be used with a conventional DMARD to manage symptoms.

Targeted synthetic DMARDs, including PDE4is and JAKis, also slow or prevent inflammation, but they target specific parts and pathways in the immune system rather than having a widespread effect, like conventional DMARDs.

Biological Therapy4,6

Biological medications are a type of non-synthetic DMARD, or disease-modifying drug, used to treat PsA and PsO. They target specific parts of the immune system.

There are several different types of biological treatment currently approved to treat PsA and PsO:

  • TNF inhibitors: these block an important protein for inflammation, called tumour necrosis factor (TNF). Treatments like this are injected under the skin or directly into a vein.
  • IL-12/23 inhibitors: these block a specific part of the proteins called interleukins (IL) 12 and 23, which are also involved in inflammation. Treatments like this are injected under the skin.
  • IL-17 inhibitors: these block a protein called IL-17 to stop inflammation from developing. Treatments like this are injected under the skin.
  • IL-23 inhibitors: treatment that targets a specific part of the protein called IL-23 to block inflammation using an injection under the skin.

If you’re going to be taking a biologic, you will probably need to be tested for tuberculosis (TB) and have blood tests before and during treatment.7

Topical Treatments8

If you also have PsO (psoriasis), topical therapy is usually the first treatment used for mild cases. There is a wide variety available, including:

  • Creams
  • Lotions
  • Gels
  • Ointments
  • Shampoos

If you also have skin plaques, topical treatments containing emollients may hydrate the skin and stop it drying out, or contain other ingredients, like vitamin D, coal tar or corticosteroids, but can take time to apply.

TOP TIP
If you want to know more about a treatment, ask your healthcare professional.

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How to prepare to see your doctor

Make every moment of the consultation really count.

Record how you’re feeling

It can be easy to lose track of how you’re doing if you don’t take note.

How to meet people with PsA

You’re not alone – there are other patients with psoriatic arthritis, just like you out there.

  1. Creaky Joints. Psoriatic Arthritis Flare-Ups: Exactly What to Do When You Get One. Available at: https://creakyjoints.org/about-arthritis/psoriatic-arthritis/psa-symptoms/psoriatic-arthritis-flare-ups/. Accessed: November 2023.
  2. NHS. Psoriasis Treatment. Available at: https://www.nhs.uk/conditions/psoriasis/treatment/#:~:text=Steroid%20creams%20or%20ointments%20. Accessed: November 2023.
  3. NHS. Psoriatic Arthritis. Available at: https://www.nhs.uk/conditions/psoriatic-arthritis/. Accessed: November 2023.
  4. Arthritis Foundation. Treatment Options for Psoriatic Arthritis. Available at: https://www.arthritis.org/health-wellness/treatment/treatment-plan/disease-management/treatment-options-for-psoriatic-arthritis. Accessed: November 2023.
  5. National Psoriasis Foundation. NSAIDs. Available at: https://www.psoriasis.org/nsaids/. Accessed: November 2023.
  6. WebMD. How DMARDs for Psoriatic Arthritis Work. Available at: https://www.webmd.com/arthritis/psoriatic-arthritis/how-dmards-psoriatic-arthritis-work. Accessed: November 2023.
  7. Rheumatology. The British Society for Rheumatology biologic DMARD safety guidelines in inflammatory arthritis—Executive summary. Available at: https://academic.oup.com/rheumatology/article/58/2/220/5076445. Accessed: November 2023.
  8. BAD. Psoriasis – topical treatments. Available at: https://www.bad.org.uk/pils/psoriasis-topical-treatments/. Accessed: November 2023.