How to treat psoriatic arthritis

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 Therapy^4,6

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.