Psoriasis Psoriatic Arthritis

Treating Psoriatic Arthritis

Many options are available to treat psoriatic arthritis (PsA), ranging from over-the-counter medicines to highly specialized therapies. Regardless of which is chosen, the overall goal is clear: Doctors seek to relieve pain and swelling, as well as slow down the joint damage associated with the disease, before it affects a patient’s ability to function and his or her quality of life.

Dermatologists may be the first physicians to identify psoriatic arthritis because it is so closely related to psoriasis; however, it is often a rheumatologist who will make the decisions about which treatment will work best. Those decisions are generally based on the severity of the disease, the number of joints involved and whether any associated skin symptoms are also present. This approach to treatment must be individualized and requires both patience and perseverance. Patients must remember that what works for one person with psoriatic arthritis may not work for someone else.

Nonsteroidal Anti-inflammatory Drugs are Often the First Line of Defense
During the early stages of the disease, mild inflammation may respond to nonsteroidal anti-inflammatory drugs (NSAIDs) that are available over-the-counter or in stronger doses by prescription. Theses drugs include aspirin, ibuprofen (Advil®, Motrin®) and naproxen (Aleve®, Naprosyn®). These drugs can decrease inflammation, reduce joint pain, and help to alleviate the morning stiffness that is commonly associated with psoriatic arthritis.

Because taking NSAIDs in high doses or for extended periods of time can have side effects, they are not for everybody. A newer type of NSAID, called a COX-2 inhibitor, has proven useful without the side effects associated with older NSAIDs, but they are more expensive and carry their own set of risks. Fortunately, other medications are available as well.

Treatment Options for the More Severe Forms of the Disease
Disease-modifying antirheumatic drugs (DMARDs) comprise several classes of medications that work by altering the way the immune system functions in an attempt to stop the underlying processes that cause the joint and tissue damage associated with psoriatic arthritis. They are often indicated as the second line of treatment for patients who are unresponsive to NSAID therapy or who have a more destructive form of the disease.

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