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.1 Different treatments work in different ways and are suitable for different situations,2 so it’s important to work with your healthcare professional to find what’s right for you. Here are the main treatment groups - find out more about what’s out there for PsA, and for PsO.
Pills or injections that act by spreading throughout the body2
Injections or infusions made from protein4
Used externally for psoriasis skin lesions14
Treatment for psoriasis skin lesions using ultraviolet rays15
The first systemic therapy you would usually be offered is a synthetic DMARD, or disease-modifying drug, like methotrexate, which suppresses an overactive immune system in psoriatic diseases like PsA and PsO.2,4 If you and your healthcare professional decide that methotrexate isn’t appropriate, or it isn’t effective, some other options may include:4,10
Biological medications are a type of non-synthetic DMARD, or disease-modifying drug, for PsA, PsO and other conditions that work within the body.3,11,12 They are grown in a lab using living cells and target specific parts of the immune system.11 These should only be prescribed by a specialist doctor with experience treating PsA or PsO, although your symptoms and side effects may be monitored by a clinical nurse specialist.4
There are a number of different types of biological treatment currently approved to treat PsA and PsO:
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.13
If you also have PsO (psoriasis), topical therapy is usually the first treatment used for mild cases.14 There is a wide variety available, including:14
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.14 If you’re taking corticosteroids, some types should only be used for a short while, so ask your healthcare professional whether you should take breaks from applying these.14
If you have PsO as well as PsA and it hasn’t improved as much as you or your healthcare professional would like with treatments applied to your skin, you may be offered short wave ultraviolet B (UVB) phototherapy 2-3 times a week.15 Another type of phototherapy you could be offered is long wave ultraviolet A (UVA) light in combination with a chemical called psoralen in tablet form.15 This is called P-UVA and is often used to treat pustules on the palms and soles of the feet, although it can’t be used in pregnant women or some people who are at a higher risk for skin cancers.15
Make every moment of the consultation really count.
It can be easy to lose track of how you’re doing if you don’t take note.
You’re not alone – there are other patients with psoriatic arthritis, just like you out there.