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Psoriatic Arthritis -- Treatment

If you have psoriatic arthritis with joint pain and stiffness, it's important to talk to your doctor about treatment. Getting the right treatment early on is important. Disease-modifying antirheumatic drugs (DMARDs) are often necessary to prevent joint destruction and disability.

What's the standard treatment for psoriatic arthritis?

The goal of psoriatic arthritis treatment is to control inflammation, stop joint destruction, and maximize joint function. Skin symptoms and joint symptoms are usually treated at the same time.

The initial treatment for psoriatic arthritis often includes nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen (Advil, Excedrin IB, Motrin). NSAIDs can provide long-term relief from the chronic pain and inflammation of psoriatic arthritis. There are many different NSAIDs, so you may have to try several NSAIDs before you find the safest and most effective one for you.


Do NSAIDs have any side effects?

Long-term use of NSAIDs can result in stomach irritation, peptic ulcers, and even bleeding, because they block production of the protective mucus layer lining the inner stomach. Certain over-the-counter and prescription medications can reverse the side effects; for example, some experts recommend taking Cytotec along with NSAIDs. Other doctors prefer to protect the stomach by giving stomach acid blockers (proton pump inhibitors such as omeprazole). Not everyone who takes NSAIDs will need a medication to protect the stomach.

What other psoriatic arthritis treatments are prescribed?

Another psoriatic arthritis treatment is corticosteroids (steroids). Corticosteroids are powerful anti-inflammatory medications that can be taken by mouth or injected directly into a joint or muscle to relieve severe pain and inflammation (the action of these steroids is very different from the muscle-building type of steroids).

Prednisone is the steroid most commonly used to treat certain rheumatic diseases such as psoriatic arthritis. However, it's important to take steroids such as prednisone only when absolutely needed. Prednisone use is associated with an increased risk of infection. Long-term use may cause serious side effects such as bone deterioration (osteoporosis), joint weakness, cataracts, weight gain, and the development of diabetes.

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