Psoriatic arthritis, when diagnosed early and accurately, can help manage symptoms effectively and stop permanent damage to the joints and disability. It does not have a cure yet.
A doctor will diagnose the disease based on the symptoms, a physical examination, the medical history of the patient and his family, and lab tests. Doctors do X-rays to determine arthritis in the hands, spine or feet. They measure bone density because psoriatic arthritis can cause bone erosion and lead to osteoporosis. They do blood tests such as erythrocyte sedimentation rate, rheumatoid factor, and anti-CCP antibody tests before they diagnose someone with psoriatic arthritis. The most obvious signs of psoriatic arthritis that even help differentiate it from rheumatoid arthritis are the changes in skin and nails. It is characterized by stiff, swollen, painful joints, fatigue, swollen fingers and/or toes, thick scaly skin, itchy skin, reddened eye, and skin. Its cause is considered to be largely genetic. Having a family history of psoriatic arthritis greatly increases one’s risk factor.
Treating the disease involves the use of drugs. Some of the drugs involved in the treatment of psoriatic arthritis include:
Immunosuppressants: These control the immune system. This is important because in a patient with psoriatic arthritis, the immune system is out of control. Examples of immunosuppressants are azathioprine such as Imuran and Azasan, and cyclosporines such as Neoral, Sandimmune, and Gengraf. However, immunosuppressants can increase a person’s susceptibility to infection.
TNF-alpha inhibitors: Tumor necrosis factor-alpha is produced by the body. It is an inflammatory substance that is responsible for stiffness and joint pain. TNF-alpha inhibitors work to reduce the stiffness of joints, especially in the mornings when it is at its worst, it relieves pain and lessens swelling and tenderness in joints. The most commonly available TNF-alpha inhibitors include etanercept (Enbrel) and infliximab (Remicade. Examples of other TNF-alpha inhibitors are certolizumab (Cimzia), adalimumab (Humira) and golimumab (Simponi). Side effects of these drugs include the risk of infection, diarrhea, nausea and hair loss.
In addition to these, medications like Otezla, Stelara, and Cosentyx that were recently developed for plaque psoriasis have been found to be effective for psoriatic arthritis too.
Besides drugs, steroid injections and joint replacement surgery are other viable options for treatment.