Table of ContentsView AllTable of ContentsNSAIDsDMARDsBiologicsBiosimilarsTarget-SpecificCorticosteroids
Table of ContentsView All
View All
Table of Contents
NSAIDs
DMARDs
Biologics
Biosimilars
Target-Specific
Corticosteroids
There is currently no cureforpsoriatic arthritis(PsA). Medicinal treatment for psoriatic arthritis (PsA) focuses on controlling inflammation to prevent joint damage and disability and includes non-steroidal anti-inflammatory drugs (NSAIDS), different types of disease-modifying anti-rheumatic drugs (DMARDs), biosimilars, and corticosteroids.
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Psoriatic arthritis is a type of inflammatory arthritis affecting people withpsoriasis, an inflammatory skin condition. Psoriasis speeds up skin cell growth, causing them to build on the surface of the skin. Symptoms of PsA include joint pain, stiffness, and swelling, along with skin lesions associated with psoriasis.
The goal of PsA treatment is to improve skin and joint symptoms. There are many medicinal options for treatment that may include one or more of the following drug therapies.
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Nonsteroidal anti-inflammatory drugs (NSAIDs) are pain relievers and, in larger doses, they can decrease inflammation. NSAIDs are effective for people whose PsA is mild.
Some NSAIDs are available over-the-counter (OTC), such as Advil and Motrin, while others require a prescription. Cox-2 inhibitors are generally prescribed for long-term conditions, including PsA, because they are believed to be safer on the stomach. However, recent studies have shown no difference in stomach side effects between NSAIDs and COX-2 inhibitors.
While most people can tolerate NSAIDs, they are not without their side effects, which include:
Which Non-Steroidal Anti-Inflammatory Drug (NSAID) Is Best?
Traditional DMARDs
Traditional disease-modifying antirheumatic drugs (DMARDs) can help to slow down or even stop the inflammatory process that would otherwise damage joints and eventually lead to disability.
Traditional DMARDs include:
These medications are also called immunosuppressants because they suppress or reduce the strength of the immune system.
The most common side effects of traditional DMARDs include:
What You Should Know About DMARDs
Biologic DMARDs
Biologic DMARDs (biologics) are used for moderate to severe PsA when other therapies have not worked.They include medications called TNF inhibitors, which block a substance called tumor necrosis factor (TNF). Too much TNF leads to inflammation.
Biologic DMARDs are expensive, so doctors won’t prescribe them unless other medications have not helped to improve symptoms.
Biologics used to treat PsA include:
Side effects of these medications include:
What Is Scleroderma?
Much like biologic DMARDs, biosimilars may regulate or even reduce inflammatory responses.While they are cheaper than biologic DMARDs, they are not generics of those medications. Moreover, like biologics, they must undergo strict Food and Drug Administration (FDA) testing.
Some biosimilars currently used in PsA treatment include:
Side effects of biosimilars include:
Target-Specific DMARDs
Currently, the only available target-specific DMARDs are Janus kinase (JAK) inhibitors. JAK is a cytokine (chemical messenger) that researchers believe plays a role in causing inflammation. In PsA and similar conditions, JAK inhibitors can reduce inflammatory responses and halt joint damage that would be a consequence of inflammation.
Target-specific DMARDs are not a first-line therapy for PsA. These medications are prescribed when a person has tried traditional and biologic DMARDs and has not gotten sufficient treatment response.
JAK inhibitor drugs available for treating PsA include:
Common side effects of JAK inhibitor drugs include:
Serious side effects of Xeljanz can include:
There is an increased risk of serious adverse events with the use of Xeljanz:
How Corticosteroid Drugs Treat Inflammation
A Word From Verywell
Your doctor can determine what medication—or medications—are right for your unique situation. It is important to keep in mind that while PsA medications can decrease pain and skin lesions, they are not a cure, and should be part a comprehensive treatment plan that includes a healthy lifestyle and complementary therapies.
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bakhriansyah M, Souverein PC, de Boer A, Klungel OH.Gastrointestinal toxicity among patients taking selective COX-2 inhibitors or conventional NSAIDs, alone or combined with proton pump inhibitors: a case-control study.Pharmacoepidemiol Drug Saf. 2017;26(10):1141-1148. doi:10.1002/pds.4183Kang EJ, Kavanaugh A.Psoriatic arthritis: Latest treatments and their place in therapy.Ther Adv Chronic Dis. 2015;6(4):194-203. doi:10.1177/2040622315582354Mobasheri A.The future of osteoarthritis therapeutics: emerging biological therapy.Curr Rheumatol Rep. 2013;15(12):385. doi:10.1007/s11926-013-0385-4Carrascosa JM, Jacobs I, Petersel D, Strohal R.Biosimilar drugs for psoriasis: principles, present, and near future.Dermatol Ther (Heidelb). 2018;8(2):173-194. doi:10.1007/s13555-018-0230-9Schwartz DM, Kanno Y, Villarino A, Ward M, Gadina M, O’Shea JJ.JAK inhibition as a therapeutic strategy for immune and inflammatory diseases.Nat Rev Drug Discov. 2017;17(1):78. doi:10.1038/nrd.2017.267U.S. Food & Drug Administration.FDA requires warnings about increased risk of serious heart-related events, cancer, blood clots, and death for JAK inhibitors that treat certain chronic inflammatory conditions.Additional ReadingArthritis Foundation.FDA approves two new drugs for psoriatic arthritis; 2017.Benjamin O, Lappin SL.Disease modifying anti-rheumatic drugs(DMARD); 2018.D’Angelo S, Tramontano G, Gilio M, et al.Review of the treatment of psoriatic arthritis with biological agents: choice of drug for initial therapy and switch therapy for non-responders.Open Access Rheumatol. 2017; 9: 21–28.doi: 10.2147/OARRR.S56073National Psoriasis Foundation.Moderate to severe psoriasis and psoriatic arthritis: Biosimilar medicines.O’Shea JJ, Kontzias A, Yamaoka K, et al. Janus kinase Inhibitors in autoimmune diseases.Ann Rheum Dis. 2013 Apr; 72(0 2): ii111–ii115. DOI: 10.1136/annrheumdis-2012-202576Ruderman EM.Overview of safety of non-biologic and biologic DMARDs. Rheumatology (Oxford). 2012;51(Suppl 6):vi37-43. doi: 10.1093/rheumatology/kes283U.S. Food and Drug Administration.Biosimilars; 2018.
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bakhriansyah M, Souverein PC, de Boer A, Klungel OH.Gastrointestinal toxicity among patients taking selective COX-2 inhibitors or conventional NSAIDs, alone or combined with proton pump inhibitors: a case-control study.Pharmacoepidemiol Drug Saf. 2017;26(10):1141-1148. doi:10.1002/pds.4183Kang EJ, Kavanaugh A.Psoriatic arthritis: Latest treatments and their place in therapy.Ther Adv Chronic Dis. 2015;6(4):194-203. doi:10.1177/2040622315582354Mobasheri A.The future of osteoarthritis therapeutics: emerging biological therapy.Curr Rheumatol Rep. 2013;15(12):385. doi:10.1007/s11926-013-0385-4Carrascosa JM, Jacobs I, Petersel D, Strohal R.Biosimilar drugs for psoriasis: principles, present, and near future.Dermatol Ther (Heidelb). 2018;8(2):173-194. doi:10.1007/s13555-018-0230-9Schwartz DM, Kanno Y, Villarino A, Ward M, Gadina M, O’Shea JJ.JAK inhibition as a therapeutic strategy for immune and inflammatory diseases.Nat Rev Drug Discov. 2017;17(1):78. doi:10.1038/nrd.2017.267U.S. Food & Drug Administration.FDA requires warnings about increased risk of serious heart-related events, cancer, blood clots, and death for JAK inhibitors that treat certain chronic inflammatory conditions.Additional ReadingArthritis Foundation.FDA approves two new drugs for psoriatic arthritis; 2017.Benjamin O, Lappin SL.Disease modifying anti-rheumatic drugs(DMARD); 2018.D’Angelo S, Tramontano G, Gilio M, et al.Review of the treatment of psoriatic arthritis with biological agents: choice of drug for initial therapy and switch therapy for non-responders.Open Access Rheumatol. 2017; 9: 21–28.doi: 10.2147/OARRR.S56073National Psoriasis Foundation.Moderate to severe psoriasis and psoriatic arthritis: Biosimilar medicines.O’Shea JJ, Kontzias A, Yamaoka K, et al. Janus kinase Inhibitors in autoimmune diseases.Ann Rheum Dis. 2013 Apr; 72(0 2): ii111–ii115. DOI: 10.1136/annrheumdis-2012-202576Ruderman EM.Overview of safety of non-biologic and biologic DMARDs. Rheumatology (Oxford). 2012;51(Suppl 6):vi37-43. doi: 10.1093/rheumatology/kes283U.S. Food and Drug Administration.Biosimilars; 2018.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Bakhriansyah M, Souverein PC, de Boer A, Klungel OH.Gastrointestinal toxicity among patients taking selective COX-2 inhibitors or conventional NSAIDs, alone or combined with proton pump inhibitors: a case-control study.Pharmacoepidemiol Drug Saf. 2017;26(10):1141-1148. doi:10.1002/pds.4183Kang EJ, Kavanaugh A.Psoriatic arthritis: Latest treatments and their place in therapy.Ther Adv Chronic Dis. 2015;6(4):194-203. doi:10.1177/2040622315582354Mobasheri A.The future of osteoarthritis therapeutics: emerging biological therapy.Curr Rheumatol Rep. 2013;15(12):385. doi:10.1007/s11926-013-0385-4Carrascosa JM, Jacobs I, Petersel D, Strohal R.Biosimilar drugs for psoriasis: principles, present, and near future.Dermatol Ther (Heidelb). 2018;8(2):173-194. doi:10.1007/s13555-018-0230-9Schwartz DM, Kanno Y, Villarino A, Ward M, Gadina M, O’Shea JJ.JAK inhibition as a therapeutic strategy for immune and inflammatory diseases.Nat Rev Drug Discov. 2017;17(1):78. doi:10.1038/nrd.2017.267U.S. Food & Drug Administration.FDA requires warnings about increased risk of serious heart-related events, cancer, blood clots, and death for JAK inhibitors that treat certain chronic inflammatory conditions.
Bakhriansyah M, Souverein PC, de Boer A, Klungel OH.Gastrointestinal toxicity among patients taking selective COX-2 inhibitors or conventional NSAIDs, alone or combined with proton pump inhibitors: a case-control study.Pharmacoepidemiol Drug Saf. 2017;26(10):1141-1148. doi:10.1002/pds.4183
Kang EJ, Kavanaugh A.Psoriatic arthritis: Latest treatments and their place in therapy.Ther Adv Chronic Dis. 2015;6(4):194-203. doi:10.1177/2040622315582354
Mobasheri A.The future of osteoarthritis therapeutics: emerging biological therapy.Curr Rheumatol Rep. 2013;15(12):385. doi:10.1007/s11926-013-0385-4
Carrascosa JM, Jacobs I, Petersel D, Strohal R.Biosimilar drugs for psoriasis: principles, present, and near future.Dermatol Ther (Heidelb). 2018;8(2):173-194. doi:10.1007/s13555-018-0230-9
Schwartz DM, Kanno Y, Villarino A, Ward M, Gadina M, O’Shea JJ.JAK inhibition as a therapeutic strategy for immune and inflammatory diseases.Nat Rev Drug Discov. 2017;17(1):78. doi:10.1038/nrd.2017.267
U.S. Food & Drug Administration.FDA requires warnings about increased risk of serious heart-related events, cancer, blood clots, and death for JAK inhibitors that treat certain chronic inflammatory conditions.
Arthritis Foundation.FDA approves two new drugs for psoriatic arthritis; 2017.Benjamin O, Lappin SL.Disease modifying anti-rheumatic drugs(DMARD); 2018.D’Angelo S, Tramontano G, Gilio M, et al.Review of the treatment of psoriatic arthritis with biological agents: choice of drug for initial therapy and switch therapy for non-responders.Open Access Rheumatol. 2017; 9: 21–28.doi: 10.2147/OARRR.S56073National Psoriasis Foundation.Moderate to severe psoriasis and psoriatic arthritis: Biosimilar medicines.O’Shea JJ, Kontzias A, Yamaoka K, et al. Janus kinase Inhibitors in autoimmune diseases.Ann Rheum Dis. 2013 Apr; 72(0 2): ii111–ii115. DOI: 10.1136/annrheumdis-2012-202576Ruderman EM.Overview of safety of non-biologic and biologic DMARDs. Rheumatology (Oxford). 2012;51(Suppl 6):vi37-43. doi: 10.1093/rheumatology/kes283U.S. Food and Drug Administration.Biosimilars; 2018.
Arthritis Foundation.FDA approves two new drugs for psoriatic arthritis; 2017.
Benjamin O, Lappin SL.Disease modifying anti-rheumatic drugs(DMARD); 2018.
D’Angelo S, Tramontano G, Gilio M, et al.Review of the treatment of psoriatic arthritis with biological agents: choice of drug for initial therapy and switch therapy for non-responders.Open Access Rheumatol. 2017; 9: 21–28.doi: 10.2147/OARRR.S56073
National Psoriasis Foundation.Moderate to severe psoriasis and psoriatic arthritis: Biosimilar medicines.
O’Shea JJ, Kontzias A, Yamaoka K, et al. Janus kinase Inhibitors in autoimmune diseases.Ann Rheum Dis. 2013 Apr; 72(0 2): ii111–ii115. DOI: 10.1136/annrheumdis-2012-202576
Ruderman EM.Overview of safety of non-biologic and biologic DMARDs. Rheumatology (Oxford). 2012;51(Suppl 6):vi37-43. doi: 10.1093/rheumatology/kes283
U.S. Food and Drug Administration.Biosimilars; 2018.
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