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There is a variety of psoriatic arthritis treatment depending on the severity of the disease and other health problems the person may have. Treatment is designed to relieve pain, reduce swelling, help keep joints working properly and potentially prevent further joint damage.
Depending on the severity of the disease, treatment may include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen sodium, which can relieve pain and reduce inflammation. Disease-modifying antirheumatic drugs (DMARDs) are given intravenously and are designed to slow or stop the progression of psoriatic arthritis and associated joint damage. These drugs, however, may cause serious side effects like liver damage, bone marrow suppression and severe lung infections.
Biologics, another class of drugs, inhibit specific molecules inside the immune cells that are associated with inflammation. These drugs act against the overactive immune response that causes inflammation, so that joint tenderness and swelling is reduced.
Sometimes steroids are injected into the joint to reduce inflammation quickly. Surgery may be required for joints that have been badly damaged by psoriatic arthritis. During surgery these joints are replaced by prosthetic joints made of plastic or metal.
Immunosuppressants such as azathioprine and cyclosporine help suppress the immune system, which overreacts in psoriatic arthritis, but these drugs can also increase the risk of infection. Tumor necrosis factor-alpha (TNF-alpha) inhibitors act against TNF-alpha, an inflammatory substance produced by the body, to reduce pain, morning stiffness and tender or swollen joints. These drugs include etanercept, infliximab and adalimumab. New oral treatments are available that are designed to improve psoriatic arthritis symptoms by inhibiting certain molecules that cause inflammation. The newest available oral treatment for psoriatic arthritis is apremilast. It inhibits the enzyme phosphodiesterase 4, or PDE4, which controls inflammatory activity inside cells.
Lifestyle changes can also be helpful for people with psoriatic arthritis. It’s important to maintain a healthy weight so that less strain is placed on the joints. Regular exercises like biking, swimming and walking can help keep the joints flexible and strengthen the muscles needed to support the joints. Cold compresses may dull the pain while heat helps muscles relax. It can also be helpful to avoid straining certain joints by, for example, using jar openers, lifting heavy objects with both hands and opening doors using the whole body instead of just the fingers or wrists.