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Psoriatic Arthritis: Medical Treatments

Psoriatic arthritis can hurt inside and out. Your doctor has many treatments to help you feel better, though.

The main goal is to control the inflammation that causes your joints to swell and hurt. That will ease your pain and help prevent further damage. 

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Your doctor may prescribe drugs. What he gives you will depend on how severe your arthritis is. To figure that out, he might take X-rays or do lab tests to see if your case is mild, moderate, or severe.

NSAIDs to Manage Mild Cases

If your arthritis is mild, your doctor may give you a non-steroidal anti-inflammatory drug (NSAID). It stops your body from making the chemicals that cause inflammation.

There are many over-the-counter and prescription NSAIDs, but your doctor will help you find the drug that works best for you. Some of the most common are ibuprofen (Advil, Motrin), naproxen sodium (Aleve), and aspirin.

What’s good for your joints may be hard on other parts of your body, though. NSAID side effects can include stomachaches, ulcers, or bleeding -- especially if you take large doses over a long time. To help, your doctor may prescribe a drug that will protect your stomach lining or something that will lower acid and prevent ulcers.  Also, a different NSAID, Celebrex, could help you if you have stomach problems.

DMARDs to Control the Disease Process

If your disease is more severe or doesn’t respond well to NSAIDs, your doctor may prescribe a disease-modifying antirheumatic drug (DMARD). These can slow or stop pain, swelling, and joint and tissue damage. 

The most often-used DMARDs aremethotrexate, leflunomide, or sulfasalazine. Your doctor may prescribe a short-term dose of the steroid prednisone, although this drug may make skin rashes worse.

Biologics: High-Powered DMARDs

If the first round of DMARDs doesn’t work, your doctor may prescribe a biologic. These drugs, a newer type of DMARD, stop your body from making a protein that causes inflammation.

You’ll probably take methotrexate along with the biologic. Most biologics are given as a shot under your skin, but some are given as an infusion into your vein in the doctor’s office, and one can be taken as a pill. Biologics work well for many people, but they have downsides.

They're expensive, and they may have side effects or risks. You may feel dizziness, sore throat, cough, stomach pain, headache, nose irritation, upper respiratory infections like colds, or have a reaction where you get your shot.

Biologics can lower your immune system's response. So if you’re taking one, let your doctor know if you get an infection like the flu. It’s also easier for you to develop tuberculosis (TB). You will be tested for it before starting your biologic and monitored while you’re on it. A biologic can also raise your chances of getting lymphoma, a blood cancer, although this is rare.

WebMD Medical Reference

Reviewed by David Zelman, MD on June 16, 2014
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