Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects the skin and joints. Symptoms include joint pain and swelling, lower back pain, eye inflammation, nail changes, and foot pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids are often used to provide pain relief.
This article explores current PsA treatments, research being explored, and potential approaches to finding a cure.
Psoriatic arthritis is an autoimmune condition in which the immune system mistakenly attacks healthy tissue, leading to pain and inflammation. PsA is chronic, which means that it is persistent and long-lasting, with no current cure. PsA requires ongoing medical attention and may require you to limit your daily living activities.
PsA symptoms can come and go and tend to vary from mild to severe. The onset of symptoms is called a flare, or flare-up. If left untreated, PsA inflammation can cause health problems, including damage to the joints, uveitis (eye inflammation), gastrointestinal problems, lung problems, weak bones, and damage to the cardiovascular system.
Though PsA is a chronic, progressive condition, it’s important to keep in mind that the right treatment can help you improve your quality of life by reducing joint pain, swelling and stiffness, and potentially preventing further damage to your joints.
Psoriatic arthritis is a multifaceted disease that affects both the skin and joints. Researchers are currently working to understand the causes of PsA and the multiple ways it affects the body. Other studies are working to identify biomarkers for PsA that can be used to predict a person’s response to certain medications. Also, new medications may be developed that can better treat the disease and promote long-term remission.
The knowledge gained from this research may lead to better diagnostics, improved treatments, ways to prevent PsA, and a potential cure. For now, the goal is to help PsA patients achieve long-term remission.
A 2021 study found that the injectable monoclonal antibody (mAb, produced in a lab) Skyrizi (risankizumab) is a potentially effective treatment against PsA. In the study, individuals with active PsA who had not experienced improvements in their symptoms when using DMARDs or biologics were given 150 milligrams of Skyrizi at the start of the trial, a month later, and three months after that.
Within 24 weeks, participants reported significant improvements in their symptoms. Some saw at least a 90% improvement in their skin, improved physical functioning, and minimal disease activity.
Biologic therapies are currently used to treat people with PsA, as they may help prevent joint damage and control disease activity. However, biologics are known to increase the risk of infection, including the potentially life-threatening sepsis and urinary tract infections (UTIs). The risk of infection makes many people hesitant to take these medications.
However, new research shows that infection rates have actually gone down in people with PsA who take biologics. These findings show that infection rates are declining, and people can feel more comfortable knowing that the increased use of biologics has not translated into a growth of serious infections.
Targeted medications taken as oral pills may soon be available for people with PsA. One oral medication, deucravacitinib, has been studied and found to work well in treating PsA. The phase 2 clinical trial (in which the trial is opened up to a larger group of patients) found that study participants who took deucravacitinib achieved a 20% improvement in symptoms.
Another oral medication, brepocitinib (a combination of TYK2 and JAK1 inhibitors) helped 35% of study participants achieve minimal disease activity after 16 weeks on the drug. Both medications are still being studied and are not currently approved for treating PsA.
Remission in PsA means that there are no signs of disease activity, including inflammatory blood markers and symptoms. In PsA, the two types of remission are:
The standard treatment approach for PsA is a “treat to target” (T2T) strategy, with the goal being minimal disease activity. This typically involves adjusting medication over time to achieve remission. The process is ongoing and may require you to have close contact with your healthcare provider over time so they can closely monitor your condition and responses to medication. They may adjust your therapies/medications so you can achieve remission or low disease activity.
You and your healthcare provider will come up with a treatment plan to get you into remission. How quickly remission occurs depends on how mild or severe your PsA is. Most experts agree that an early and accurate diagnosis and starting treatment as early as possible increase the chances of remission and make it last.
Once remission is achieved, you may wonder if it is safe to stop taking your medication. Relapse rates are quite high when medications are discontinued, and drug-free remission is quite rare.
A 2015 study found that disease relapse is high after stopping treatment. Researchers suggested that stopping treatment is not realistic because the risk of flare-ups is higher when not taking medications.
There are many treatments available for psoriatic arthritis. Your PsA treatment plan may include medications, physical therapy and/or occupational therapy, exercise, rest, and complementary therapies like massage and acupuncture. Following your treatment plan can help reduce the symptoms of the disease and prevent joint damage caused by arthritis.
Medications are commonly used to treat PsA. Options include:
Following your treatment plan can help reduce the signs and symptoms of PsA. Lifestyle changes and CAM may also help you manage and better cope with the disease, including:
Many people with PsA turn to CAM options to help reduce symptoms. Consult with your healthcare provider before seeking out CAM options. There are many different alternative therapies to consider to complement your traditional treatment, including:
Everyone is different, so finding the treatments that are right for you may take time, trial, and error. Stay in close communication with your healthcare provider to find the treatments that are most effective for you.
Psoriatic arthritis research is constantly evolving, and new medications and therapies that show promise for reducing symptoms and disease activity are currently being studied. In order to develop a cure, scientists must first understand the underlying causes of PsA. As more treatments become available, the medical community can fine-tune approaches to treatment, creating a treatment plan for every person with PsA.
While there is not yet a cure for PsA, continued research and advancements are paving the way for more effective treatments. Research is helping healthcare providers better understand the causes and mechanisms that lead to PsA, offering promise for a cure in the future.
Psoriatic arthritis is a chronic autoimmune disease that does not yet have a cure but can be successfully treated. The causes of PsA have not yet been identified, but genetics, lifestyle, and the immune system are all believed to play a role.
Treatment of PsA may involve medication, lifestyle changes, and complementary therapies. A combination of these can help manage symptoms, control disease progression, and improve your quality of life. Researchers continue to explore potential treatments for PsA, and there is hope that a cure will be discovered in the future.
If you have psoriatic arthritis, it’s important to get diagnosed and treated early in order to keep the disease from progressing. Biologics and DMARDs are the current standard treatments for PsA, and researchers are studying potentially new treatments to reduce symptoms and limit disease activity.
While researchers still have a long way to do to develop a cure, discoveries are happening all the time, and there is hope for a cure in the future. For now, it’s important to focus on taking medications that can help ease your symptoms and improve your quality of life.
Clinical trials help researchers and healthcare providers learn about potential treatments to improve the health of those who live with PsA. Participating in a clinical trial offers you access to new treatments that may help reduce your symptoms and improve your quality of life.
Clinicaltrials.gov is an online resource that allows you to search for clinical trials that are recruiting participants. You can search for trials that are local to you and others that allow participants to be involved remotely.
Starting treatments early after diagnosis and following your treatment plan can help achieve remission. Additionally, implementing healthy lifestyle choices such as a healthy diet, weight management, and joint-friendly exercises, as well as staying in close communication with your healthcare provider, can help you slow disease progression and make remission possible.
Approximately 30% of people with psoriasis will develop psoriatic arthritis. Both conditions involve abnormal immune responses. With psoriasis, the immune system misfires and causes skin cells to grow too quickly, causing red, scaly plaques on the skin. With PsA, the immune system leads to joint inflammation and pain.
In 2021, new medications, such as monoclonal antibodies (risankizumab) and oral medications (deucravacitinib, brepocitinib) are currently in phase 3 clinical trials. These medications show promise for slowing disease progression, reducing PsA symptoms, and potentially helping promote remission.