Psoriatic arthritis (PsA) is a chronic autoimmune condition that affects the joints and the skin, causing inflammation, pain, and stiffness. It is closely related to psoriasis, a skin condition that causes red, scaly patches, and can lead to joint damage over time. Fortunately, various drugs are available to manage the symptoms of psoriatic arthritis, reduce inflammation, and improve joint function.

Understanding Psoriatic Arthritis

Psoriatic arthritis is a type of inflammatory arthritis that occurs in some people with psoriasis. The condition can cause joint pain, swelling, and stiffness, often leading to permanent damage if left untreated. In addition to joint involvement, psoriatic arthritis can also affect tendons and ligaments, a condition known as enthesitis. The exact cause of PsA is not fully understood, but it is believed to be linked to genetic and environmental factors, such as infections or trauma that can trigger inflammation.

Types of Psoriatic Arthritis Drugs

There are several classes of drugs that can help manage psoriatic arthritis. These drugs target different aspects of the disease and aim to relieve pain, reduce inflammation, and prevent long-term joint damage.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs are often the first line of treatment for managing the pain and inflammation associated with psoriatic arthritis. These drugs reduce inflammation in the joints and can provide temporary relief from symptoms such as pain, swelling, and stiffness.

• How they work: NSAIDs block the enzymes responsible for producing prostaglandins, chemicals that cause inflammation and pain.
• Common drugs: Ibuprofen (Advil, Motrin), naproxen (Aleve), and diclofenac (Voltaren).
• Benefits: They provide quick relief from pain and inflammation.
• Considerations: NSAIDs can have side effects like gastrointestinal irritation, so they should be used cautiously, especially for long-term management.

Disease-Modifying Antirheumatic Drugs (DMARDs)

DMARDs are medications that aim to slow the progression of psoriatic arthritis and reduce joint damage. They work by targeting the immune system to reduce inflammation and prevent the disease from worsening over time.

Traditional DMARDs

These drugs are usually prescribed when NSAIDs are not enough to manage symptoms. They take longer to work but are important in preventing joint damage.

• Common drugs: Methotrexate, sulfasalazine (Azulfidine), and leflunomide (Arava).
• How they work: Traditional DMARDs suppress the immune system to reduce inflammation.
• Benefits: They help slow disease progression and protect the joints from damage.
• Considerations: DMARDs can have side effects such as nausea, liver damage, and increased susceptibility to infections, so regular monitoring is necessary.

Biologic DMARDs

Biologics are a newer class of DMARDs that specifically target immune system components involved in inflammation. These drugs are usually prescribed when traditional DMARDs are ineffective or cause too many side effects.

• Common drugs: Tumor necrosis factor inhibitors (TNF inhibitors) such as etanercept (Enbrel), adalimumab (Humira), infliximab (Remicade), and interleukin inhibitors like ustekinumab (Stelara) and secukinumab (Cosentyx).
• How they work: Biologics block specific proteins or cells in the immune system that trigger inflammation, thus reducing joint damage and controlling symptoms.
• Benefits: Biologics are highly effective at controlling psoriatic arthritis symptoms, especially for moderate to severe cases.
• Considerations: Biologics are administered through injections or infusions and require close monitoring for side effects, such as increased risk of infections.

Janus Kinase (JAK) Inhibitors

JAK inhibitors are a newer class of oral medications that target specific pathways in the immune system that cause inflammation. These drugs are taken by mouth and can be an option for those who cannot tolerate biologics or prefer an oral treatment.

• Common drugs: Tofacitinib (Xeljanz) and upadacitinib (Rinvoq).
• How they work: JAK inhibitors block enzymes called Janus kinases, which are involved in the signaling pathways that promote inflammation.
• Benefits: These drugs offer convenience with oral administration and can be effective for treating psoriatic arthritis when other treatments are not sufficient.
• Considerations: JAK inhibitors can increase the risk of infections, blood clots, and certain cancers. Regular blood tests and monitoring are required.

Corticosteroids (Steroids)

Corticosteroids, often referred to as steroids, are powerful anti-inflammatory medications that can be used to quickly reduce inflammation and pain in psoriatic arthritis. They can be administered orally, as injections, or topically (for skin lesions related to psoriasis).

• Common drugs: Prednisone, methylprednisolone, and triamcinolone (for injections).
• How they work: Steroids suppress the immune system and reduce inflammation throughout the body.
• Benefits: They provide rapid relief from inflammation and can be used to manage flare-ups of symptoms.
• Considerations: Long-term use of corticosteroids can lead to side effects such as weight gain, osteoporosis, and increased susceptibility to infections.