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How do we Treat Psoriatic Arthritis?

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If you have been given a diagnosis of psoriatic arthritis, do not panic! There are many effective therapies already available and great progress has recently been made. The last 10 years has seen a number of highly effective medications become available.

Symptoms can worsen for a period of time (a flare) and then settle down. About 1 in 20 people will have a more severe form of arthritis with damage to the joints of their hands and feet, however most people are still able to lead active and full lives.

Anti-inflammatories are often used to control symptoms, but they are not effective at preventing disease progression, except for spinal involvement. Corticosteroids may very occasionally be used to control inflammation in the short term, however, there is a risk of flaring skin disease when doing this.

Disease-modifying anti-rheumatic drugs (DMARDs) are medications which alter parts of the immune response and dampen down inflammation and prevent permanent joint damage. Methotrexate, leflunomide and sulfasalazine are the most commonly used drugs in this category.

Biological DMARDs have revolutionised treatment over the last ten years. They are highly effective at controlling both inflammation and preventing damage. These drugs include Enbrel, Humira, Remicade, Cimzia and Simponi and are given by injections under the skin or infusions into the vein. These medications are very effective but very expensive so there are strict controls in place through Medicare so that only patients with disease that have not responded to other medications will have access to them.

Most patients with psoriatic arthritis will require long-term treatment and thus it is very important to have regular blood tests and review with your rheumatologist.