Psoriatic arthritis is a chronic, inflammatory disorder of joints associated with psoriasis, a chronic skin disease. Hence, the treatment for psoriatic arthritis is aimed to reduce the symptoms of arthritis and psoriasis as well as other involved organs. This disease causes inflammation of joints which results in pain, redness and stiffness of joints as well as patchy red skin, pitted and discolored nails and eye inflammation.
The treatment for psoriatic arthritis focuses on reducing pain and managing the symptoms. Various treatment options are medications to treat arthritis and psoriasis, therapies like topical therapy, phototherapy and systemic therapy and exercise. Medications used for the treatment of arthritis are analgesics, non-steroidal anti-inflammatory drugs, disease-modifying anti-rheumatic drugs and corticosteroids.
The analgesics like paracetamol are useful to reduce the pain of arthritis. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, aspirin, tolemetin sodium (Tolectin), diclofenac (Voltaren) and indomethacin (Indocin) effectively reduce inflammation, stiffness and pain in joints. They can cause some side-effects such as stomach upset and ulceration as well as gastrointestinal bleeding. In addition to this, newer NSAIDs known as COX-2 inhibitors such as Celebrex or celecoxib are also found to be beneficial for the treatment for psoriatic arthritis. They less frequently cause the gastrointestinal problems.
Disease-modifying anti-rheumatic drugs (DMARDs) such as methotrexate, sulfasalazine (Azulfidine), the antimalarial drug hydroxychloroquine (Plaquenil) and gold salts help to control the amount of joint damage along with relieving pain and inflammation. However, the action of DMARDs is slow and it may take few weeks or even months showing effects. The side-effects of sulfasalazine are loss of appetite, vomiting and nausea. Besides this, side effects of methotrexate are dizziness, diarrhea, nausea and fatigue.
Antimalarial medications like hydroxychloroquine (Plaquenil) can be useful for persistent psoriatic arthritis. Leflunomide (Arava) is an effective treatment for both psoriasis and psoriatic arthritis. In addition to this, corticosteroids are effective anti-inflammatory agents which can be given orally or can be directly injected into the joints to decrease the inflammation and minimize the joint damage. If used for prolonged time, they can cause the side-effects such as thinning bones (osteoporosis), easy bruising, diabetes, cataracts, decreased resistance to infection and high blood pressure.
Recently, three new medications are proved to be effective for the treatment of severe psoriatic arthritis. If DMARDs does not work, you may apply the TNF-blockers such as infliximab (Remicade), etanercept (Enbrel) and adalimumab (Humira) is found to be useful for severe psoriatic arthritis which significantly improve psoriasis as well as arthritis and prevent the progressive joint damage. Abdominal pain, headache, dizziness and respiratory problems are some of the side-effects of these drugs.
Treatment for psoriasis includes oral medications, creams and ointments and use of ultraviolet light (phototherapy). Oral medications for psoriasis include retinoids such as isotretinoin (Amnesteem, Accutane) and acitretin (Soriatane). However, they can cause sun sensitivity, eye and lip inflammation, liver toxicity and bone thinning. Besides this, topical medications include coal tar, anthralin, steroids, vitamin D analogues, retinoids, and moisturizers.
Although there are some side-effects of medications used for the treatment for psoriatic arthritis, they can be overcome by medical treatment. These drugs can significantly relive the pain of arthritis and reduce the symptoms.
