Treatment for Psoriatic Arthritis Tailored to Individual Needs

Medically Reviewed By William C. Lloyd III, MD, FACS

Treatment for psoriatic arthritis depends on many factors, such as severity of symptoms, location of disease, and individual health. And what works well for one person may not work for another.

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If you've struggled with psoriasis symptoms, you know that there's no one-size-fits-all treatment. The same is true for psoriatic arthritis.

Thankfully, with many psoriatic arthritis treatment options available, therapy can be tailored to your specific condition and needs. Talk with your doctor about what type of treatment may be best for you. Managing your arthritis can reduce joint pain and stiffness as well as improve range of motion and your quality of life. Some therapies can even slow or stop progression of joint damage due to the disease.

Here are common treatment options for psoriatic arthritis.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDS, such as naproxen (Aleve) and ibuprofen (Advil), are often the first line of treatment for psoriatic arthritis. NSAIDs are available in both over-the-counter and prescription strengths and can reduce joint pain and inflammation.

Although traditional NSAIDs are inexpensive and widely available, they aren't right for everyone. In some people, NSAIDs can increase the risk for stomach problems, such as ulcers and bleeding. If you have these problems, you might be a candidate for a COX-2 inhibitor such as celecoxib (Celebrex). These newer NSAIDs cause fewer stomach-related side effects. However, COX-2 inhibitors are also much more expensive than traditional NSAIDs, and they may increase your risk of a heart attack.

Disease-Modifying Antirheumatic Drugs (DMARDs)

If you don't find symptom relief with NSAIDs or already have joint damage, your doctor may prescribe a DMARD. These drugs work to suppress the body's overactive immune system, which causes arthritic inflammation. DMARDs are available in two major categories: traditional or systemic DMARDs and biologic response modifier drugs (biologics).

Traditional DMARDs

There are many traditional or systemic drugs shown to treat psoriatic arthritis effectively. Some have been used for decades to treat psoriatic arthritis. The most common include:

  • Acitretin (Soriatane)
  • Cyclosporine (Neoral and Sandimmune)
  • Leflunomide (Arava)
  • Methotrexate (Rheumatrex)
  • Sulfasalazine (Azulfidine)

Traditional DMARDs are taken orally or given by injection and may take a few months to be effective. They reduce joint pain and stiffness for many people with psoriatic arthritis. Some also slow progression of the disease. People taking systemic drugs are closely monitored by their doctors because they can have an increased risk for liver or kidney damage with long-term use.

Biologics

Biologic drugs, which are made from human or animal protein molecules, are newer drugs that have shown excellent results in people with psoriatic arthritis. They help slow the progression of joint damage by targeting specific molecules that promote inflammation. Biologics that are effective for psoriatic arthritis include:

  • Etanercept (Enbrel)
  • Golimumab (Simponi)


Although biologics have greatly improved treatment options for psoriatic arthritis, they aren't always the initial treatment that's prescribed. That's because they are expensive, making them unaffordable for many people without good health insurance. Also, many insurance companies require patients to try a traditional DMARD before approving payment for biologics.

Other Treatment Options

If damage to the joints becomes severe, joint repair or replacement surgery is an option to improve function and range of motion and improve your quality of life. Corticosteroid shots can also temporarily relieve severely swollen joints. However, they aren't considered a long-term therapy for psoriatic arthritis.

Self-Care

In addition to medication treatment, there are other things you can do to reduce psoriatic arthritis symptoms. These include:

  • Engaging in regular physical activity

  • Resting and icing your joints during a flare-up

  • If you smoke, getting help to quit


Although no one treatment option works for everyone, there are now many effective therapies for psoriatic arthritis. By working closely with your doctor, you can find a treatment that works for you.

Key Takeaways

  • Treatment for psoriatic arthritis depends on many factors, such as your symptoms, location of disease, and individual health.

  • NSAIDS, such as naproxen and ibuprofen, are often the first line of treatment, reducing joint pain and inflammation.

  • Your doctor may prescribe a disease-modifying antirheumatic drug (DMARD) or a biologic drug, which work to suppress the body's overactive immune system.

  • Other treatments may include corticosteroid shots and surgery.

  • Self-care helps, too, such as getting regular exercise, quitting smoking, and applying heat and cold to painful joints. 

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  1. Psoriatic Arthritis. Arthritis Foundation. http://www.arthritis.org/about-arthritis/types/psoriatic-arthritis/
  2. Disease-modifying Anti-rheumatic Drugs (DMARDs). The Psoriasis and Psoriatic Arthritis Alliance. http://www.papaa.org/psoriatic-arthritis-treatments/disease-modifying-anti-rheumatic-drugs-dmards
  3. About Psoriatic Arthritis. National Psoriasis Foundation. https://www.psoriasis.org/about-psoriatic-arthritis
  4. Your role in treatment. National Psoriasis Foundation. https://www.psoriasis.org/access-care/informed-patient/your-role
  5. Diagnosing Psoriatic Arthritis. National Psoriasis Foundation. https://www.psoriasis.org/psoriatic-arthritis/diagnosis
  6. Disease-modifying Antirheumatic Drugs (DMARDs). National Psoriasis Foundation. https://www.psoriasis.org/psoriatic-arthritis/treatments/dmards
  7. Moderate to Severe Psoriasis and Psoriatic Arthritis: Biologic Drugs. National Psoriasis Foundation. https://www.psoriasis.org/about-psoriasis/treatments/biologics
  8. Nonsteroidal Anti-inflammatory Drugs (NSAIDS). National Psoriasis Foundation. https://www.psoriasis.org/psoriatic-arthritis/treatments/nsaids
  9. Traditional Systemic Medications. National Psoriasis Foundation. https://www.psoriasis.org/about-psoriasis/treatments/systemics
  10. Psoriatic Arthritis. American College of Rheumatology. http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Psoriatic-Arthritis
  11. How Cigarettes and Alcohol Affect Psoriasis. National Psoriasis Foundation. https://www.psoriasis.org/advance/how-cigarettes-and-alcohol-affect-psoriasis
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2022 Aug 11
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