What Treatment Options Are Available for Psoriatic Arthritis?

Treatment for psoriatic arthritis (PsA) varies. It depends on the severity of the disease, specific symptoms, and reaction to treatment.¹

There is no cure for PsA. But there are many treatment options that can help. The goals of treating PsA are to:¹

• Provide relief from the symptoms of pain, swelling, and stiffness
• Protect the joints and prevent the disease from getting worse
• Maintain mobility and prevent disability

In some cases, treatment may lead to remission. Remission means that symptoms go away for a period of time. They may even disappear entirely.²

How is PsA severity determined?

The severity of PsA can range from mild to severe. Mild PsA affects only a few joints. Severe PsA affects 5 or more joints and lowers your quality of life. With severe PsA, daily tasks can be hard and painful. No matter how severe your PsA is, the disease has a big impact on your physical and mental well-being.^3,4

Your doctor can tell you whether you have mild, moderate, or severe PsA. Knowing the severity of your PsA helps your doctor determine the best treatment approach.^4,5

Treatment guidelines for PsA

Several groups have created specific guidelines for treating PsA. For example, in 2018 the National Psoriasis Foundation and the American College of Rheumatology released updated treatment guidelines. These are evidence-based guidelines for the treatment of PsA.^5,6

The most widely used PsA treatment guidelines have a treat-to-target approach. Treat-to-target means that medicines and other treatments are adjusted as needed to reach treatment goals. This method has gained popularity in recent years. It may become the standard of care for PsA.^2,5

Guidelines often change as new treatments and research become available. Talk with your doctor about which treatments are right for you.

Treatment options for PsA

There are several treatment options for PsA, including:^5-7

• Non-steroidal anti-inflammatory drugs (NSAIDs) – help reduce inflammation and pain
• Corticosteroids – provide temporary symptom relief and can be taken as a pill or injection
• Traditional disease-modifying anti-rheumatic drugs (DMARDs) – reduce inflammation and slow or stop joint and tissue damage
• Biologic DMARDs – designed to target specific proteins like tumor necrosis factor and interleukins
• Biosimilars – a type of biologic therapy that is highly similar to an already-approved biologic product
• Target-specific DMARDs – work on specific cellular enzymes to reduce inflammation and help relieve joint pain, swelling, and stiffness

There also are non-drug treatment options for PsA. These include physical therapy and light therapy (phototherapy). Physical and occupational therapy are often important ways to protect the joints and maintain function.^5-8

What is combination therapy?

Doctors sometimes recommend combination therapy for PsA. This means using multiple treatment options at the same time. The goal of combination therapy is to reach the best treatment outcomes.^5,6

For example, one drug may be used to boost the efficacy or minimize the side effects of another drug. Combination therapy allows your doctor to tailor treatment for you. This is useful when traditional PsA treatments are not working.^5,6

Do people with PsA get joint surgery?

In severe cases of PsA, surgery may be needed. A minimally invasive surgery in which a camera guides the surgeon's work (arthroscopic surgery) on the synovial capsule has been effective for some people. The synovial capsule helps to lubricate the joints. Joint replacement or reconstructive surgery also may be needed in serious cases.^6,7

Complementary and alternative treatment options

There are several complementary treatments that some people with PsA find helpful. These include:^7,8

• Massage
• Acupuncture
• Herbal remedies

Before starting any type of alternative therapy, talk with your doctor.

Adopting healthy lifestyle changes

Healthy lifestyle habits also are important ways to help manage PsA symptoms. These habits may include:^7,8

• A balanced diet
• Regular exercise
• Stress reduction methods
• Physical therapy
• Not smoking