Currently, there is no cure for psoriatic arthritis, so treatments tend to focus on controlling joint inflammation and preventing discomfort, joint damage, or disability. Your doctor will recommend treatment options based on how severe your joint disease is, with the goal of complete remission or minimal disease activity.
There are several oral medications available for the treatment of psoriatic arthritis. These treatments work to reduce inflammation and improve symptoms such as joint pain.
Biological response modifiers or biologics are considered a highly effective treatment option for patients with psoriatic arthritis. Biologics act by targeting specific areas of your immune system to block either a particular cell or protein which contributes to pain and inflammation. Most biologics are currently given by injection just under the skin (subcutaneous injection) and can be administered by a nurse or by the patient themselves after proper training. Some treatments are given by intravenous (IV) infusion at a day clinic or hospital under medical supervision.
Biologics are generally divided into groups based on how they work:
- TNF inhibitors
- IL-12/23 inhibitors
- IL-23 inhibitors
- IL-17 inhibitors
- CTLA-4 Ig
A biosimilar (also referred to as a subsequent entry biologic) is a similar but not identical version of a biologic (also called a reference or originator biologic). Biosimilars become available on the market once the patent for the reference drug has expired. The originator drug is the first of its kind and as such, its developers get to be the sole manufacturer for a certain length of time. Once that time is up, others are permitted to sell biosimilars, which are similar to the originator but not exactly the same. It is impossible to make an identical copy of a biologic due to its complexity, but we can make very close approximations. Additional testing and research are done on biosimilars to ensure that they are just as safe and effective as the originator.
Biologic medications can be expensive, so most manufacturers have patient support programs (PSPs) that help people access their drug. PSPs can help you navigate insurance, reduce medication costs, and obtain coverage for their drugs.
Symptomatic therapies are medications that can help to manage the symptoms of psoriatic arthritis such as pain but are not usually used alone as a long-term treatment. Medications for symptomatic management include:
- Local glucocorticoid injections
Many patients may benefit from non-drug therapies such as physical therapy, occupational therapy, smoking cessation, weight loss, massage therapy, or exercise.