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Other Medicines Used to Treat Psoriatic Arthritis

Reviewed by: HU Medical Review Board | Last reviewed: February 2024 | Last updated: February 2024

Several kinds of medicines are available to treat psoriatic arthritis (PsA). Some medicines work better than others for different people. The most common types of drugs used to treat PsA include:1

But other drugs that are not classified as NSAIDs, DMARDs, or corticosteroids may also be used to treat adults with PsA.

Examples of other medicines used to treat psoriatic arthritis

Examples of other drugs used to treat PsA include:2-4

  • Acthar® (corticotropin)
  • Cyclosporine
  • Imuran® (azathioprine)

Acthar (corticotropin)

Acthar is a long-acting gel that is injected under the skin or into a muscle. Acthar works with the immune system to help reduce inflammation. It is used to treat PsA flares at times when symptoms suddenly worsen. Acthar can be an additional, short-term treatment used with other treatments for PsA.2,3

Common side effects of Acthar include:2,3

  • Fatigue
  • Fluid retention
  • Headache
  • Changes in behavior and mood
  • Changes in appetite
  • Weight gain
  • Difficulty falling asleep or staying asleepIncreased blood sugar

Acthar can increase the risk of infections. Long-term use of Acthar can affect the adrenal gland, which can cause symptoms of Cushing’s syndrome. After stopping long-term treatment with Acthar, the adrenal glands may not produce enough cortisol on their own. This is called adrenal insufficiency.3

Do not use Acthar if you are pregnant, planning to become pregnant, or breastfeeding.3

For more information, read the full prescribing information of Acthar.

Cyclosporine

Cyclosporine is a drug that suppresses the immune system. It was first used to help prevent organ transplant rejection. The US Food and Drug Administration (FDA) has approved its use for adults with severe psoriasis. This drug is most often prescribed when other treatments have not worked.4

Cyclosporine works by reducing or blocking certain immune system functions that cause inflammation in people with psoriasis or PsA. It can be taken as a pill or liquid form.4

Cyclosporine is available under the brand names:5

  • Gengraf®
  • Neoral®
  • Sandimmune®

Common side effects of cyclosporine include:4,5

  • Headache
  • Diarrhea
  • Heartburn
  • Gas
  • High blood pressure
  • Kidney damage
  • Muscle or joint pain
  • Difficulty sleeping
  • Burning or tingling feelings in hands, arms, feet, or legs

Do not take cyclosporine if you have:4

  • A compromised immune system
  • Kidney problems
  • High blood pressure
  • Cancer or a history of cancer
  • Gout

Do not take cyclosporine if you are pregnant or planning to become pregnant.4

Cyclosporine may increase the risk of serious infections and certain cancers, including lymphoma and skin cancer. This risk may be increased if cyclosporine is used in combination with certain other drugs.4

For more information, read the full prescribing information of cyclosporine.

Imuran (azathioprine)

Imuran is used to treat several autoimmune conditions. It works by suppressing the immune system, which is overactive in people with PsA. Imuran is also used to treat people who have had organ transplants to prevent rejection of the transplanted organ.6-8

Common side effects of Imuran include:6-8

  • Nausea
  • Vomiting
  • Diarrhea

Taking Imuran with food may help reduce side effects.6

Imuran has a boxed warning, the strictest warning from the US Food and Drug Administration (FDA). It has this warning because Imuran may increase the risk of certain cancers including skin cancer and lymphoma.6-8

Before taking Imuran, tell your doctor if you are pregnant or planning to become pregnant.6,8

For more information, read the full prescribing information of Imuran.

Other things to know

These are not all the possible side effects of Acthar, cyclosporine, or Imuran. Side effects can vary depending on the specific drug you are taking. Talk to your doctor about what to expect when taking one of these drugs. You also should call your doctor if you have any changes that concern you when taking one of these drugs.

Before beginning treatment for PsA, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.

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Treatment results and side effects can vary from person to person. This treatment information is not meant to replace professional medical advice. Talk to your doctor about what to expect before starting and while taking any treatment.