What are Other Medications Used to Treat PsA?

Several different kinds of medications are available to treat psoriatic arthritis (PsA), and some medications work better than others for individual patients. Types of medications for PsA include non-steroidal anti-inflammatory drugs (NSAIDs), disease-modifying anti-rheumatic drugs (DMARDs), corticosteroid injections, and other medications. This article focuses on the other medications that aren’t classified as either an NSAID, corticosteroid, or DMARD.

The other medications that may be used for treating PsA include:

Acthar

H.P. Acthar Gel (repository corticotropin injection) is a long-acting gel that is injected under the skin (subcutaneously) or into a muscle. It is used to treat psoriatic arthritis flares at times when symptoms suddenly worsen. Acthar can be an additional, short-term treatment to other ongoing treatments for psoriatic arthritis. Acthar is classified as a hormone, and as such, works with the hormonal system of the body.1,2

Common side effects experienced with Acthar are fluid retention, changes in blood sugar, high blood pressure, changes in behavioral and mood, increased or decreased appetite, weight gain, and difficulty falling asleep or staying asleep. Acthar can cause side effects similar to those with steroid treatments, and it can increase the risk of infections. After taking Acthar long-term, the adrenal gland may produce too much cortisol, which can cause symptoms of Cushing’s syndrome. Sometimes, after stopping long-term treatment with Acthar, the adrenal glands may not produce enough cortisol on its own, a condition called adrenal insufficiency.1

Cyclosporine

Cyclosporine is available under the brand names Sandimmune® (cyclosporine), Neoral®(cyclosporine), and Gengraf® (cyclosporine). Cyclosporine is one of the primary systemic medications used in the treatment of more severe types of psoriasis and is classified as an immunosuppressant drug. It works by reducing or blocking certain immune system factors that cause the inflammation in PsA.3

Cyclosporine may increase the risk of certain cancers, including lymphoma and skin cancer. This risk may be increased if cyclosporine is used in combination with certain other medications, and it is important that patients talk to their doctor about all medications, herbal supplements, and vitamins they are taking. Cyclosporine may also cause side effects such as high blood pressure, kidney damage, headache, diarrhea, muscle or joint pain, depression, difficulty sleeping, and burning or tingling of the hands, arms, feet, or legs.4

Imuran

Imuran (azathioprine), in addition to treating psoriatic arthritis, it is used to treat several autoimmune conditions and in people who have had organ transplants to prevent rejection of the transplanted organ. It works by suppressing the immune system, which is overactive in diseases like PsA.5

Imuran may increase the risk of certain cancers, and this risk may be elevated in people who have had a kidney transplant. The most common side effects experienced with Imuran are related to the digestive system and taking the medication with food may help reduce these side effects. Side effects may include nausea, vomiting, and diarrhea.5,6

Xeljanz

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. In conditions like PsA, the inflammatory response is overactive, and JAK inhibitors can reduce the inflammation and may stop joint damage that can be a long-term complication of PsA.7,8

Xeljanz may cause side effects, and some of them may be serious, including reducing a person’s ability to fight infections. Some infections can be life-threatening, and people should be tested for tuberculosis (TB) before starting treatment with Xeljanz. The most common side effects experienced with Xeljanz are upper respiratory infections, colds, headache, changes in cholesterol levels and diarrhea.7,8

Written by: Emily Downward | Last reviewed: April 2018.
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