Treatment of Psoriatic Arthritis
Treating psoriatic arthritis varies depending on the level of pain, swelling and stiffness. Those with very mild arthritis may require treatment only when their joints are painful and may stop therapy when they feel better. Non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin or Advil) or naproxen (Aleve) are used as initial treatment.

If the arthritis does not respond, disease modifying anti-rheumatic drugs may be prescribed. These include sulfasalazine (Azulfidine), methotrexate (Rheumatrex, Trexall, Otrexup, Rasuvo), cyclosporine (Neoral, Sandimmune, Gengraf), and leflunomide. Sometimes combinations of these drugs may be used together. The anti-malarial drug hydroxychloroquine (Plaquenil) can help, but it usually is avoided as it can cause a flare of psoriasis. Azathioprine (Imuran) may help those with severe forms of psoriatic arthritis.

There are several biologic type medications available to treat psoriatic arthritis via infusion or injection.

The TNF Inhibitors such as adalimumab (Humira), etanercept (Enbrel), golimumab (Simponi), certolizumab (Cimzia) and infliximab (Remicade) are also available and can help the arthritis as well as the skin psoriasis.

Secukinumab (Cosentyx), a new type of biologic injection, was recently approved to treat psoriatic arthritis and also can be helpful in treating psoriasis.

Ustekinumab (Stelara) is a biologic injection given in your doctor’s office that is effective in treating psoriatic arthritis and psoriasis.
Abatacept is given to patients who have not responded to one or more DMARDs or other biologic drugs. Abatacept may be used alone or in combination with DMARDs.

For swollen joints, corticosteroid injections can be useful. Surgery can be helpful to repair or replace badly damaged joints.