Adjusting psoriatic arthritis medications: Advice from a Mayo Clinic expert
Finding the right medications for your psoriatic arthritis symptoms may take time and patience, but you can find relief by working closely with your rheumatologist.
The most important part of finding effective treatment for psoriatic arthritis is you — your treatment goals, your symptoms and your quality of life. Get expert input on the best approach.
Finding the right medications for your psoriatic arthritis symptoms can be frustrating at times, but it can be done. You may need to try multiple types and combinations of treatments before you find relief that works for you.
In this interview, April Chang-Miller, M.D., a rheumatologist at Mayo Clinic's campus in Arizona with a special interest in psoriatic arthritis, explains what to expect during the process of finding your best treatment plan, and how to get the best results.
What can I expect while trying to find the right psoriatic arthritis medications?
Know that it often takes time to find the right psoriatic arthritis medications — and dosages. Your rheumatologist will work closely with you to find the best treatment plan.
You play the most important role in this process. Tell your doctor how you feel when taking medication and if your symptoms get better, worse or stay the same. The information you share about how you're responding to each medication plays a critical role in determining whether you need any medication adjustments.
Don't give up if you're not feeling better right away. It may take some time, but most people with psoriatic arthritis have significant symptom relief within one year of treatment.
What steps are involved in finding the right medication?
Your doctor will recommend a personalized treatment plan based on many things, including the severity of your symptoms, other medications you take and your overall health.
When you begin a new psoriatic arthritis medication, you'll need regular checkups. During these visits, you'll likely have lab tests done and talk to the doctor about any changes in your symptoms since you started the medication.
As you learn more about how the drug is affecting you, your doctor may adjust your dosage. Psoriatic arthritis medication dosages often need to be increased gradually, to reduce side effects as you find your maximum dosage.
If the medication isn't helping your symptoms or it's causing side effects, your doctor may recommend trying a different drug.
The overall goal is to find a treatment plan that provides dramatic relief from your symptoms. Your doctor may refer to this relief as minimal disease activity.
How likely is it that psoriatic arthritis medications will significantly improve my symptoms?
With regular and careful follow-up care from your rheumatologist, noticeable symptom relief is a realistic goal.
Research has shown that most people with psoriatic arthritis who keep tight control of their treatment (regular checkups, lab tests and medication adjustments) have measurable relief within a year of starting their medications.
If my symptoms improve or disappear, can I stop taking medications?
Your rheumatologist will probably recommend against stopping medication, and for good reason. Psoriatic arthritis symptoms often return after stopping drug treatment.
Once your symptoms improve, your doctor may suggest decreasing your dosage or the total number of medications you take. If symptoms return, you and your doctor can discuss new adjustments to get back to significant relief.
What else can I do to help my treatment plan be effective?
Follow all aspects of your treatment plan — which is likely to include more than just medications. A well-rounded treatment plan may include physical or occupational therapy to learn:
- Exercises to help keep your joints flexible and maintain a healthy weight, since being overweight can decrease the effectiveness of medications
- New ways to do daily tasks without putting extra stress on your joints, such as using assistive devices
- Self-care methods to ease symptoms, such as heat and cold therapies
By working closely with your rheumatologist, and giving the process time, you have a very good chance of finding a treatment plan that works for you long term.
Jan. 08, 2019
See more In-depth
- How to achieve remission in psoriatic arthritis. Arthritis Foundation. http://www.arthritis.org/about-arthritis/types/psoriatic-arthritis/articles/psa-drug-free-remission.php. Accessed Dec. 17, 2018.
- Elsevier Point of Care. Psoriatic arthritis. https://www.clinicalkey.com/. Accessed Dec. 17, 2018.
- Gladman D, et al. Treatment of psoriatic arthritis. https://www.uptodate.com/contents/search. Accessed Dec. 17, 2018.
- Canzoni M, et al. Clinical and ultrasonographic predictors for achieving minimal disease activity in patients with psoriatic arthritis: the UPSTREAM (Ultrasound in PSoriatic arthritis TREAtMent) prospective observational study protocol. BMJ Open. 2018;8:e021942.
- Chang-Miller A (expert opinion). Mayo Clinic, Phoenix/Scottsdale, Ariz. Dec. 21, 2018.