Psoriatic Arthritis
What is psoriatic arthritis?
Psoriatic arthritis is a chronic autoimmune disease where the body’s immune system attacks the joints. This causes inflammation of the joints and joint swelling. It can be associated with psoriasis. About ⅓ of people with psoriasis can develop psoriatic arthritis. It is important to treat psoriatic arthritis quickly to prevent irreversible damage.
RheumInfo: Psoriatic Arthritis
https://rheuminfo.com/en/diseases/psoriatic-arthritis/
Patient Journey: Psoriatic Arthritis
https://arthritis.ca/treatment/your-patient-journey/psoriatic-arthritis-en
How is psoriatic arthritis treated?
The first medication used to treat psoriatic arthritis is either sulfasalazine and/or methotrexate. These medications help control the immune system. Methotrexate works well to control psoriasis as well.
RheumInfo Methotrexate:
https://rheuminfo.com/en/medications/methotrexate/
RheumInfo Sulfasalazine:
Click to access Sulfasalazine-Patient-Guide-RheumInfo_EN.pdf
What can I do to help control my psoriatic arthritis?
- Exercise. Regular exercise improves pain and inflammation in psoriatic arthritis. The general recommendation is at least 30 minutes of moderate to vigorous activity five times per week. Moderate to vigorous is defined as difficult to breath, but able to hold a conversation. Strength training twice per week is also important to build muscle.
- Diet. The best diet supported by evidence is the Mediterranean diet. This diet is high in omega 3. It is mainly comprised of fish (twice weekly), fruits and vegetables, nuts and olive oil. Try to reduce your consumption of packaged and processed foods (e.g., bread that has additives, premade salad dressings, etc.)
- Alcohol. Reduce alcohol intake, ideally to none. There are great alcohol-free alternatives on the market.
- Smoking. If you smoke, you should discuss strategies for quitting with your primary care practitioner or pharmacist.
- Weight. Target normal body weight. There is evidence that patients with excess weight (e.g., BMI over 25) have worse psoriatic arthritis that is harder to treat.
What are biologics?
If sulfasalazine and methotrexate do not work, there are many biologic options. Biologics are advanced medications that target a specific part of the immune system that causes psoriatic arthritis.
These medications are expensive (over $1,000 per month), but they are covered by BC Pharmacare in patients who meet criteria. In order to meet criteria, patients must have a diagnosis of psoriatic arthritis and must have tried methotrexate and sulfasalazine, but continued to have active disease or side effects.
Below are the biologic options covered by BC Pharmacare:
RheumInfo: Adalimumab
RheumInfo: Certolizumab
RheumInfo: Infliximab
RheumInfo: Golimumab
RheumInfo: Etanercept
RheumInfo: Tofacitinib
RheumInfo: Ixekizumab
RheumInfo: Secukinumab
RheumInfo: Bimekizumab
RheumInfo: Ustekinumab
/https://rheuminfo.com/docs/medications/pictos/Ustekinumab-Patient-Guide-RheumInfo_EN.pdf
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