Adjusting psoriatic arthritis medications: Advice from a Mayo Clinic expert
Finding the right medicines for psoriatic arthritis symptoms can take time and patience, but you can find relief by working closely with your rheumatologist.
Finding the right medicines for your psoriatic arthritis might take time, but it's important to keep going. You might need to try a few treatments until you find what works best for you.
The most important part of finding treatment that works for psoriatic arthritis is you: Your treatment goals, your symptoms and your quality of life.
April Chang-Miller, M.D., is a rheumatologist at Mayo Clinic's campus in Arizona. She has a special interest in psoriatic arthritis. Here she discusses what to expect from the search for your best treatment plan and how to get the best results.
What can I expect while looking for the right psoriatic arthritis medicines for me?
It takes time to find both the right psoriatic arthritis medicines and the right amounts. Your rheumatologist will work closely with you to find your best treatment plan.
You play the most important role in this process. Tell your health care provider how you feel on each medicine you try and what it does for your symptoms. This will help your provider adjust medicines as needed.
You might not feel better right away. Don't give up. It can take time to feel better. But most people with psoriatic arthritis get a lot of symptom relief within one year of treatment.
How does finding the right medicine work?
Your health care provider will suggest a treatment plan based on your symptoms, how bad they are, other illnesses you have and other medicines you take.
When you begin a new psoriatic arthritis medicine, you're likely to see your care provider regularly. These appointments often include lab tests. Talk to your provider about changes in your symptoms since you started the medicine.
As you learn more about how the medicine works for you, your provider might change the amount you take. Some psoriatic arthritis medicine doses can be adjusted, if needed, to help the medicine work better for you and keep side effects down.
If the medicine isn't working the way you want or if your side effects are bad, your provider might change the medicine or the dose.
The goal is to give you the most relief from your symptoms, also known as minimal disease activity.
How likely is it that psoriatic arthritis medicines can make my symptoms better?
With regular follow-up care from your rheumatologist, you're likely to get relief from your symptoms.
Research has shown that most people with psoriatic arthritis who keep tight control of their treatment get relief that can be measured within a year of starting their medicines. Tight control means having regular checkups and lab tests, and changing medicines or doses as needed. More research is needed.
If my symptoms get better or go away, can I stop taking medicines?
That's not likely to be a good idea. Psoriatic arthritis symptoms often come back after stopping treatment.
But once your symptoms improve, you might be able to take fewer medicines or less of the ones you take. Your care provider can adjust your medicines when your symptoms are under control. And if your symptoms come back, other changes can get you back to symptom relief.
What else can I do to help my treatment plan work well?
Besides taking your medicines as prescribed, follow all parts of your treatment plan. For example, your care provider might send you to a physical or occupational therapist to learn:
- Exercises to help keep your joints moving and to stay at a healthy weight. Being overweight can make medicines not work as well.
- New ways to do daily tasks without putting extra stress on your joints. This might involve using tools known as assistive devices.
- Self-care ways to ease symptoms. This might include using heat and cold to sooth sore joints.
Work with your rheumatologist. Take the advice you're given. Give the process time. Then you have a good chance of finding a treatment plan that works for you long term.
March 21, 2023
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- Singh JA, et al. 2018 American College of Rheumatology/National Psoriasis Foundation guideline for the treatment of psoriatic arthritis. Arthritis & Rheumatology. 2019; doi:10.1002/art.40726.
- How to achieve remission in psoriatic arthritis. Arthritis Foundation. https://www.arthritis.org/diseases/more-about/how-to-achieve-remission-in-psoriatic-arthritis. Accessed Jan. 16, 2023.
- Rayes HA, et al. Consensus-based recommendations on the diagnosis, referral and clinical management of patients with psoriatic arthritis. Rheumatology International. 2022; doi:10.1007/s00296-021-05029-5.
- What is the right treatment for PsA? National Psoriasis Foundation. https://www.psoriasis.org/advance/what-is-the-right-treatment-for-psa/. Accessed Jan. 16, 2023.
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