Some doctors start with NSAIDS (nonsteroidal anti-inflammatory medications)—medications that block inflammation within the joints. There are prescription and non-prescription varieties on nonsteroidal anti-inflammatory medications. Generally, the prescription varieties are stronger.
Psoralens such as Methoxsalen and Trioxsalen are used to treat psoriatic arthritis. These are drugs that make the body more sensitive to light and are used along with phototherapy for psoriatic arthritis. This type of therapy is known as PUVA and uses a psoralen drug along with UV-A light therapy to treat the disease. Psoralens are taken by mouth a few hours before receiving light therapy for maximum effectiveness. Treatment takes about 20-30 times but about 85 percent of afflicted patients report an improvement in their symptoms. Treatment is often done 2-3 times for week until the symptoms resolve and then every 2-4 weeks after that. There is always a risk of skin cancer, cataracts or sunburn.
Enbrel or Etanercept is the first FDA-approved medication for the treatment of psoriatic arthritis. It is considered a manmade protein that works directly with the immune system to block inflammation. Patients receive twice weekly injections with the site rotated to include the thigh, the upper arm or the abdomen. It can be given at home so that a patient doesn’t have to show up at the doctor’s office every couple of days.
Methotrexate is a commonly used drug to treat plaque-type psoriasis plus or minus the addition of psoriatic arthritis. This is a medication that suppresses the immune system and reduces the growth and production of skin cells. It is taken by mouth or by injection and cannot be taken by pregnant women or by men who plan to impregnate a woman. You need to have your blood cell count, your liver function and your kidney function checked while on this medication.
Cyclosporine is an immunosuppressant drug that reduces the inflammation of the joints and slows the production of skin cells. One takes the drug orally just once per day. Your kidney and liver function must be checked regularly and the drug can increase the risk for high blood pressure, lymphoma and infection.
Alefacept or Amevive is a medication recently approved for the treatment of psoriatic arthritis and psoriasis. It slows the production of skin cells and blocks inflammation. It is given as a once-weekly injection. One problem with Alefacept is that it can increase the risk of cancer, infection or allergy to the drug. Bleeding at the injection site is possible.
Adalimumab or Humira was approved in 2005 for the treatment of psoriatic arthritis. It is given as a self-administered injection once every two weeks. You can’t take the drug if you have an active infection. It suppresses the ability of the immune system to work and can cause allergies in a person. Sometimes antibodies develop to the drug, which makes it less effective.
Infliximab or Remicade was also approved in 2005 for psoriatic arthritis. It is an IV infusion given over 2 hours. The doctor needs to give this type of injection. When it is given over a six-week period of time, it is then given approximately every eight weeks. It has similar side effects to other injectable agents for psoriatic arthritis.
Surgery is inevitable for 7 percent of people who suffer from psoriatic arthritis. Surgery usually involves replacing a particularly damaged joint and usually involves a large joint.
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