The Decision to Switch Treatments for Psoriatic Arthritis
Once you are diagnosed with psoriatic arthritis (PsA), your doctor will work with you to put together a treatment plan. There is no 1 set treatment for PsA. What works for 1 person may not work for another. You might start out with 1 treatment and have to try another. This is frustrating but all normal.
What does treatment usually involve?
There is no cure for PsA, so treatment is aimed at treating the symptoms like joint pain or swelling. Treatment also works to minimize long-term damage to joints. Treatment is often based on:1
- The signs and symptoms of your PsA
- How severe your PsA symptoms are
- Whether you have any other health conditions
When should I think about switching treatments?
There are different kinds of PsA treatments that may be used, depending on your symptoms. You may have to switch treatments at different times. It is especially common to switch treatments early in your treatment to find the one that works best for you. There are several factors that may cause you to switch treatments.
Disease-modifying anti-rheumatic drugs (DMARDs) are often prescribed for PsA because they are effective, but they may come with side effects. This is because they are systemic. This means they work on the entire body. Side effects can include:2,3
- Upset stomach
- Hair loss
- Mouth sores
- Skin problems
- Liver, kidney, or lung problems
Biologic DMARDs are also used to treat PsA. These drugs have fewer side effects because they are more targeted. These can include:3
- Redness, swelling, bruising, or itching at the injection site
- Sinus infection
If you have side effects that interfere with your life and do not lessen over time, it may be time to talk with your doctor about trying a new drug.
The treatment is not working
There is no 1 specific medicine for PsA. You may find that you get no relief from the first drug you try. There are a variety of drugs for PsA. If 1 does not work for you, let your doctor know. They can look at your treatment history, symptoms, and medical history. This can help them pick another drug that might help.
Sometimes people with PsA take more than 1 drug because combinations can be more effective than a single drug. It can also take several weeks to months for drugs to take full effect.2
Cost of treatment
The cost of treatment may be high, and insurance may not always cover all of it. If your out-of-pocket costs are getting to be too expensive, call your insurance company. Ask them about various PsA drugs and brands and how much they will cover each.
Talk with your doctor. Be honest about the financial strain and ask if there is a biosimilar drug like the one you are taking. A biosimilar is a drug that is highly similar to an original, FDA-approved biologic drug. These can be less expensive than the original drug but just as effective.4
With some biologic DMARDs, you can self-inject them at home. If you are squeamish about that, you might want to switch. Some people find it more comforting to have a medical professional administer their drug or infusion.1
Other people may find reactions around the injection site to be bothersome. A drug with less frequent injections can make treatment a little more bearable.1
Sticking to your treatment plan is key to minimizing symptoms. If the treatment is not going to be taken as prescribed because of side effects, it is not the right treatment for you.
Things to consider
PsA is a chronic condition. If a medicine is not consistently working for you in any way, tell your doctor. There are other medicines out there, and they can address your symptoms and help improve your quality of life. Together with your doctor, you can find the drug that is best for you.
Do you have a sleep disorder (eg. insomnia, sleep apnea, RLS) in addition to your PsA?