Psoriatic arthritis: It is a form of Arthritis in a patient who is already suffering from psoriasis. Psoriasis is a condition in which red patches and silvery scales are developed over the skin.
Generally, people suffering from psoriasis may develop Arthritis later.
Stiffness, swelling, and joint pain are the common symptoms of this arthritis.
Diagnosis: This disease is diagnosed by two methods.
Imaging tests: X-rays and Magnetic resonance imaging (MRI) is done to check for the presence of arthritis. This test is done to check the actual size, shape, and structure of the tumor.
Laboratory tests: Rheumatoid factor (RF) test and Joint fluid test is done to determine arthritis by removing a small sample of fluid from the joints.
Treatment: Some effective drugs used in the treatment of arthritis are:
NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to reduce inflammation and pain.
DMARDs: Disease-modifying antirheumatic drugs slows down the progression of psoriatic arthritis.
Biological therapy: Enbrel, Cimzia, Humira, and Remicade are shown to be safe and effective when taken with methotrexate
Immunosuppressive: It suppresses the immune system which controls arthritis.
Few medications which are helpful in psoriatic Arthritis treatment are mentioned below:
1. Apremilast:
This medication belongs to phosphodiesterase 4 (PDE-4) inhibitor class drug that is used for the treatment of active psoriatic arthritis and moderate to severe plaque psoriasis.
This drug is available in tablet form of concentration 10mg, 20mg, and 30mg. This tablet is taken orally with or without food. The doctor recommends not to chew, Crush, or split the tablet. Tablet is contraindicated to be used in a person who has known hypersensitivity with any active ingredient of this pill.
Some of the common side effects of using apremilast medication are listed below:
Diarrhea
Nausea
Vomiting
Headache
Upper respiratory tract infection
Indigestion
The patient has severe renal impairment is recommended to lower the dosage of medication.
There are certain medications that affect the working of apremilast 30 mg in the human body. Such drugs are pyrimidine, phenytoin, phenobarbital, rifabutin, and rifampin.
2. Tofacitinib:
Tofacitinib is a Janus Kinase Inhibitor class drug that is used for the treatment of active psoriatic arthritis in adults who has an intolerance to methotrexate or any other disease-modifying antirheumatic drugs (DMARDs). This drug is also very effective in the case of rheumatoid arthritis and ulcerative colitis.
This drug is available in tablet form of concentration 5 mg, 10 mg, and 11 mg. This tablet is taken with or without food once or twice a day.
Tofacitinib 5 mg is not recommended to women who are breastfeeding as it can pass through breast milk to the baby causing potential damage. Some common side effects of this drug include headache, upper respiratory tract infection, diarrhea, and nasopharyngitis.
Rifampin is the drug that affects the removal of tofacitinib in the body and also interrupts its normal functioning.
This drug is stored at 15°C and 30°C.
3. Etanercept:
Etanercept belongs to the tumor necrosis factor (TNF) blocker used for the treatment of psoriatic arthritis, rheumatoid arthritis, plaque psoriasis, polyarticular Juvenile idiopathic arthritis, and Ankylosing Spondylitis.
It is available in injection form of concentration 25 mg and 50 mg single-use vial. This drug does not cure the autoimmune disease completely rather this disease returns after one month of stopping the medication.
It is generally not administered in the case of a pregnant woman and hence pregnancy should be avoided. Overdose of etanercept 50 mg injection may cause infection or injection sight reaction.
Certain drugs such as cyclophosphamide, abatacept, azathioprine, and rilonacept disturb the removal of drugs from the body and also differ the concentration of injection.
This drug is stored in refrigerator temperature ranging from 36°F and 46°F, or 2°C and 8°C but this can also be stored from 68°F and 77°F, or 20°C and 25°C for about 14 days.
4. Tacrolimus:
This drug belongs to a calcineurin-inhibitor immunosuppressant class that is used for the treatment of psoriatic arthritis. It is also effectively used in the treatment of organ transplantation such as kidney, heart, or liver transplant.
This drug is available in capsule form of concentration 0.5mg, 1 mg, and 5 mg and in injection form of strength 5mg/ml. Doctors recommend using this capsule as a whole, do not break the capsule. This medication should not be used in a patient having known hypersensitivity with any active ingredient of this drug.
Some of the severe adverse reaction of tacrolimus 1 mg are:
Hypertension
Hypophosphatemia
Tremor
Abnormal renal function
Diarrhea
Headache
Constipation
Anemia
Some drugs such as nefazodone, cimetidine, methylprednisolone, danazol, and Ethinyl estradiol affect the concentration of this drug in the body.
This capsule is stored at +4°C or −20°C, keep in a cool and dry place away from sunlight.
5. Adalimumab:
Adalimumab is a tumor necrosis factor blocker that is used for the treatment of psoriatic arthritis, rheumatoid arthritis, plaque psoriasis, and Crohn's disease.
It is available in syringe form of concentration 40 mg/0.8 mL.
Some common side effects of this drug include headache, rash, upper respiratory tract infection, sinusitis, Increased alkaline phosphatase, Blood in the urine, and High blood pressure (hypertension).
This drug also exists in different brands such as adalimumab-atto, Humira, and Amjevita.
This drug was approved by the United State in 2002. It is one of the safest and effective medicines included in the Health Organization's List of Essential Medicine.
6. Golimumab:
This medication is a tumor necrosis factor (TNF) blocker indicated for the treatment of psoriatic arthritis and moderates to severe rheumatoid arthritis. It is either used alone or in combination with the methotrexate.
It is available in two concentrations present in a single-dose syringe of strength 50mg/0.5mL and 100 mg/1 mL. This injection is administered after the proper training in subcutaneous injection technique by healthcare professionals or by self.
Some common side effects of this drug include upper respiratory tract infection, injection site reaction, and nasopharyngitis.
Some drugs which may interact with the golimumab are etanercept, adalimumab, certolizumab, cyclosporine, and anakinra.
This drug is stored at 36°F to 46°F (2°C to 8°C) away from the light. Do not shake or freeze the injection.
7. Ustekinumab:
Ustekinumab (Stelara) was approved in 2013 in order to treat adult patients with moderate to severe psoriatic arthritis. This medicine was initially approved in 2009 in order to treat psoriasis.
Ustekinumab may be used alone or together with methotrexate, giving patients with PsA who haven’t responded to other existing treatment options.
This drug comes in order to be administered as an injection under the skin (subcutaneous injection) through a pre-filled syringe, avoiding areas of the psoriasis. Following the very initial dose you'll be administered another at 4-weeks, then every 12-weeks from then on. Some most commonly reported side effects of ustekinumab are headache, upper respiratory infection, and tiredness.
8. Abatacept:
Abatacept was approved in the year of 2017 in order to treat psoriatic arthritis in adult patients. Abatacept (Orencia) was already approved in order to treat RA (rheumatoid arthritis) and in order to treat a single subtype of juvenile idiopathic arthritis (JIA).
Technically named a selective costimulation modulator, this medication acts in order to target T-cells (T-lymphocytes). These immune cells are basically overproduced in individuals struggling with inflammatory arthritis.
This medication attaches to the surface of the T-lymphocytes and blocks the communication between these cells. It is also involved in stopping the production of the chemicals that may be responsible for the joint damage and signs like pain/swelling.
Abatacept may be administered as a monthly infusion or weekly injection and could be responsible for causing some side effects, which may include lower respiratory tract infections, herpes infections, cough, urinary tract infections, pneumonia, flu, high blood pressure, diarrhea, nausea, stomach pain, vomiting, mouth sores, upset stomach, local injection site reactions, weakness, elevated transaminases, rashes, fatigue, and systemic injection reactions.
9. Sulfasalazine:
Sulfasalazine (SSZ), also named Azulfidine, is a medication used in order to treat psoriatic arthritis.
It specifically falls under disease-modifying antirheumatic drugs (DMARDs) family of medications, and should be swallowed whole through a glass of water.
It is not recommended to crush or chew the sulfasalazine tablets. Your healthcare provider will instruct you on the appropriate dose to take.
In patients taking sulfasalazine tablets, some side effects may occur, which include loss of appetite, headache, nausea, bone marrow suppression, rash, liver problems, Stevens Johnson syndrome, and kidney problems. Use of this medication should be avoided in people allergic to sulfonamide/aspirin.
10. Certolizumab:
Certolizumab, also named Cimzia, specifically is a biologic medication.
On September 27'th, 2013, the Food and Drug Administration approved Certolizumab in order to treat adult patients struggling with active psoriatic arthritis.
As a biologic drug, certolizumab pegol falls under the class of medications known as the anti-TNFs or TNF blockers, and administered by subcutaneous injection (injection under the skin) into the thigh/tummy.
Some most commonly reported side effects of certolizumab include rash, upper respiratory tract infection, and urinary tract infection.
11. Infliximab:
Infliximab, specifically is a chimeric monoclonal antibody, also named Remicade. It is a medicine used in order to treat a number of autoimmune diseases including psoriatic arthritis.
Falls under the chimeric monoclonal antibody biologic, infliximab acts by binding to as well as neutralizing the TNF-α, preventing it from interacting through its receptors on the cell.
Infliximab comes in order to be administered by slow injection into a vein, typically at 6 to 8 week intervals.
Some commonly reported side effects due to the infliximab may include abdominal pain, infections, and acute infusion reactions.
NOTE: The piece of information mentioned about "List of few medications which are helpful in psoriatic Arthritis treatment" in this article is just for the informational purposes and is not served as a substitute for medical treatment, consultation, diagnosis of a qualified doctor.