Is Remission Possible With Psoriatic Arthritis?

Reviewed by: HU Medical Review Board | Last reviewed: June 2022

Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects the joints. PsA fluctuates, and symptoms can get worse or better over time. A person with PsA may have periods of time when symptoms are more intense and periods when symptoms go away (remission).1

Experts think PsA is caused when genetic factors are triggered by environmental factors, such as an infection or trauma. There is no known cure for PsA. However, there are treatment options that can help reduce symptoms. They may even help you reach remission.1,2

What does remission mean?

Remission is defined as the absence of inflammatory disease activity. Put more simply, it means symptoms go away for a period of time. During remission, there is little to no joint pain or inflammation. There is also the potential for damaged joints to heal.2,3

For those with PsA, remission is the ultimate goal. But it can take some trial and error to achieve. PsA symptoms can vary from person to person. This makes it difficult to measure remission. Monitoring your symptoms and triggers, as well as working with your healthcare team, can help.1,2

How is remission achieved?

Remission can be achieved through different treatment methods and therapies. Treatment affects quality of life for people with PsA. The earlier you begin treatment, the greater your chance of remission.2

Treatments include:1

  • Non-steroidal anti-inflammatory drugs (NSAIDs) – These drugs are typically used for people with mild PsA. Over-the-counter medicines like ibuprofen are an example.
  • Disease-modifying anti-rheumatic drugs (DMARDs) – This type of prescription drug is for people with a more active or severe case of PsA. These drugs work with the immune system to help reduce swelling, pain, and inflammation.
  • Biologics – Biologics are drugs that are designed to target parts of the immune system that trigger inflammation. Examples of biologics that help stop inflammation include tumor necrosis factor (TNF) inhibitors and interleukin (IL) 17 and 12/23 inhibitors.
  • Steroid injections – These injections are used for severe inflammation when other treatment methods are not working.

How is remission measured in PsA?

Modern imaging techniques like magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound are used to look at inflammation and damage to the joints.2

However, it is more common to spot remission by looking at a person’s symptoms and using clinical tools that deal with joint pain and swelling. Sometimes lab tests that measure inflammation are also used to help measure remission in PsA.1

The Psoriatic Arthritis Response Criteria (PsARC) is a tool used to monitor PsA. It can be a helpful tool to measure remission as well. A PsARC exam assesses:1

  • Joint tenderness
  • Joint swelling
  • A person’s opinion on their PsA symptoms and overall health
  • A doctor’s opinion of a person’s PsA symptoms and overall health

During the physical exam, a doctor examines the joints for tenderness and swelling. This is called a 66/68 joint count. It looks at 66 joints for swelling and 68 joints for tenderness and pain with movement. Some of the joints that are examined for joint tenderness are 1

  • Hands
  • Wrists
  • Feet
  • Elbows
  • Shoulders
  • Hips
  • Knees

Other methods that measure PsA disease activity include:1Disease Activity in Psoriatic Arthritis (DAPSA) and Psoriatic Arthritis Joint Activity Index (PsAJAI).

Regular PsA assessments are key to treating the disease and reaching remission. Imaging outcomes for remission are still evolving. But the more assessment tools there are, the greater impact they may have on treatment options and a person’s overall quality of life.1-3

Work with your doctor

New research continues to help doctors understand PSA and how remission can be achieved. Living with PsA can be challenging, but remission is possible. Work with your doctor to determine what treatment method might be right for you.

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