What Types of Medicines are Used to Treat Psoriatic Arthritis?
There are several different kinds of drugs used to treat psoriatic arthritis (PsA). The treatments for PsA can be organized into several categories, including:
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Traditional disease-modifying anti-rheumatic drugs (DMARDs)
- Biologic DMARDs
- Target-specific DMARDs
- Other medicines
What are NSAIDs?
NSAIDs are among the most commonly used pain medicines. They also decrease inflammation at higher doses. NSAIDs can be an effective treatment for mild PsA. Most people tolerate NSAIDs well, but side effects are possible.1,2
Some NSAIDs are available over-the-counter, while others are available only with a prescription. NSAIDs include aspirin, ibuprofen, naproxen, and other generic and brand-name drugs.1
What are corticosteroids?
Corticosteroids, also called glucocorticoids or steroids, are drugs that mimic the hormone cortisol. This hormone reduces inflammation in the body. Corticosteroids can be taken by mouth or are injected into affected joints in people with PsA.3
What are traditional DMARDs?
Traditional DMARDs are drugs that slow or stop the inflammatory process that can damage joints and lead to long-term disability. Traditional (or non-biologic) DMARDs include methotrexate, Azulfidine® (sulfasalazine), and Arava® (leflunomide). It also includes antimalarial drugs such as Plaquenil® (hydroxychloroquine) and Aralen® (chloroquine phosphate).4,5
What are biologic DMARDs?
Biologic DMARDs are drugs made from living cells. These cells can come from parts of the blood, proteins, viruses, or tissue. This process creates drugs that can prevent, treat, and cure disease. In people with PsA, they work by interfering with specific substances in the immune system to reduce or better regulate the inflammatory responses that cause PsA and psoriasis symptoms. Common proteins targeted include tumor necrosis factor (TNF) and various interleukins (IL). Biologic DMARDs include:2,5
- Cimzia® (certolizumab pegol)
- Cosentyx® (secukinumab)
- Enbrel® (etanercept)
- Humira® (adalimumab)
- Orencia® (abatacept)
- Remicade® (infliximab)
- Simponi® (golimumab)
- Simponi Aria® (golimumab)
- Stelara® (ustekinumab)
- Taltz® (ixekizumab)
- Tremfya® (guselkumab)
What are biosimilars?
Biosimilars are drugs that are highly similar to an already-approved biological product. Like biologics, biosimilars have man-made proteins that mimic certain functions in human genes or cells, and they are made from living organisms. Biosimilars used in the treatment of PsA include:6,7
- Amjevita™ (adalimumuab-atto)
- Cyltezo® (adalimumab-adbm)
- Erelzi™ (etanercept-szzs)
- Inflectra® (infliximab-dyyb)
- Ixifi™ (infliximab-qbtx)
- Renflexis™ (infliximab-abda)
What are target-specific DMARDs?
Target-specific DMARDs work by targeting certain enzymes to help reduce the inflammatory response that causes joint pain, swelling, and stiffness. Target-specific DMARDs used to treat PsA include Otezla® (apremilast). Otezla is an oral systemic and phosphodiesterase 4 (PDE4) inhibitor. PDE4 inhibitors suppress parts of the immune response, such as cell recruitment and activation of inflammatory cells.8,9
Xeljanz® (tofacitinib) and Xeljanz XR® (tofacitinib): Xeljanz and the extended-release version Xeljanz XR are Janus kinase (JAK) inhibitors. JAK is a type of cytokine, or chemical messenger, that is believed to play a role in inflammation.11
RINVOQ (upadacitinib) is another target-specific DMARD.
What other types of medicines are used to manage psoriatic arthritis?
There are several other drugs that may be used for treating PsA including:5, 10
- Cyclosporine – Available under the brand names Sandimmune®, Neoral®, and Gengraf®, cyclosporine is one of the primary systemic drugs used to treat more severe types of psoriasis. It is an immunosuppressant drug and works by reducing or blocking certain immune system factors that cause inflammation in PsA./li>
- Imuran® (azathioprine) – Imuran is used to treat several autoimmune conditions. It works by suppressing the immune system, which is overactive in diseases like PsA.
- Otezla® (apremilast)
- Acthar® Gel (repository corticotropin injection)