While there is no cure for psoriatic arthritis, it is possible to achieve remission with the help of medication. Treatments include disease-modifying antirheumatic drugs (DMARDs) and biologics.
This article explores current PsA treatments, research being explored, and potential approaches to finding a cure.
Chronic Nature of Psoriatic Arthritis
Psoriatic arthritis is an autoimmune condition in which the immune system mistakenly attacks healthy tissue, leading to pain and inflammation. PsA is chronic, which means that it is persistent and long-lasting, with no current cure. PsA requires ongoing medical attention and may require you to limit your daily living activities.
PsA symptoms can come and go and tend to vary from mild to severe. The onset of symptoms is called a flare, or flare-up. If left untreated, PsA inflammation can cause health problems, including damage to the joints, uveitis (eye inflammation), gastrointestinal problems, lung problems, weak bones, and damage to the cardiovascular system.
Where Research Is Now
Psoriatic arthritis is a multifaceted disease that affects both the skin and joints. Researchers are currently working to understand the causes of PsA and the multiple ways it affects the body. Other studies are working to identify biomarkers for PsA that can be used to predict a person’s response to certain medications. Also, new medications may be developed that can better treat the disease and promote long-term remission.
The knowledge gained from this research may lead to better diagnostics, improved treatments, ways to prevent PsA, and a potential cure. For now, the goal is to help PsA patients achieve long-term remission.
Monoclonal Antibody Treatment Research
A 2021 study found that the injectable monoclonal antibody (mAb, produced in a lab) Skyrizi (risankizumab) is a potentially effective treatment against PsA. In the study, individuals with active PsA who had not experienced improvements in their symptoms when using DMARDs or biologics were given 150 milligrams of Skyrizi at the start of the trial, a month later, and three months after that.
Within 24 weeks, participants reported significant improvements in their symptoms. Some saw at least a 90% improvement in their skin, improved physical functioning, and minimal disease activity.
Infection Rates in People with PsA Are Declining
Biologic therapies are currently used to treat people with PsA, as they may help prevent joint damage and control disease activity. However, biologics are known to increase the risk of infection, including the potentially life-threatening sepsis and urinary tract infections (UTIs). The risk of infection makes many people hesitant to take these medications.
However, new research shows that infection rates have actually gone down in people with PsA who take biologics. These findings show that infection rates are declining, and people can feel more comfortable knowing that the increased use of biologics has not translated into a growth of serious infections.
New Oral Therapies for PsA Are Emerging
Targeted medications taken as oral pills may soon be available for people with PsA. One oral medication, deucravacitinib, has been studied and found to work well in treating PsA. The phase 2 clinical trial (in which the trial is opened up to a larger group of patients) found that study participants who took deucravacitinib achieved a 20% improvement in symptoms.
Another oral medication, brepocitinib (a combination of TYK2 and JAK1 inhibitors) helped 35% of study participants achieve minimal disease activity after 16 weeks on the drug. Both medications are still being studied and are not currently approved for treating PsA.
Odds of Going Into Remission
Remission in PsA means that there are no signs of disease activity, including inflammatory blood markers and symptoms. In PsA, the two types of remission are:
Drug-induced: Low disease activity when you are actively taking medications, such as biologicsDrug-free: Low disease activity, relief from symptoms without medication, or both
The standard treatment approach for PsA is a “treat to target” (T2T) strategy, with the goal being minimal disease activity. This typically involves adjusting medication over time to achieve remission. The process is ongoing and may require you to have close contact with your healthcare provider over time so they can closely monitor your condition and responses to medication. They may adjust your therapies/medications so you can achieve remission or low disease activity.
Can I Relapse Once I Am in Remission?
Once remission is achieved, you may wonder if it is safe to stop taking your medication. Relapse rates are quite high when medications are discontinued, and drug-free remission is quite rare.
A 2015 study found that disease relapse is high after stopping treatment. Researchers suggested that stopping treatment is not realistic because the risk of flare-ups is higher when not taking medications.
Treatment for Psoriatic Arthritis
There are many treatments available for psoriatic arthritis. Your PsA treatment plan may include medications, physical therapy and/or occupational therapy, exercise, rest, and complementary therapies like massage and acupuncture. Following your treatment plan can help reduce the symptoms of the disease and prevent joint damage caused by arthritis.
Medications
Medications are commonly used to treat PsA. Options include:
Nonsteroidal anti-inflammatory drugs (NSAIDs): These drugs help reduce pain, inflammation, and swelling. Over-the-counter (OTC) options are Advil or Motrin (ibuprofen) and Aleve (naproxen), and stronger NSAIDs are available by prescription. Corticosteroids: Steroids may be injected into the affected joints to reduce pain and swelling. Disease-modifying anti-arthritic drugs (DMARDs): These medications reduce inflammation and pain, and some prevent arthritis from progressing and damaging joints. You may be prescribed one or two different DMARDs to provide the most effective treatment.
Lifestyle and Complementary and Alternative Medicine (CAM)
Following your treatment plan can help reduce the signs and symptoms of PsA. Lifestyle changes and CAM may also help you manage and better cope with the disease, including:
Conventional DMARDs, including Arava (leflunomide), Azulfidine (sulfasalazine), and Otrexup (methotrexate) Targeted DMARDs, such as Xeljanz (tofacitinib) Biologic DMARDs, to include Enbrel (etanercept), Humira (adalimumab), and Remicade (infliximab)
Anti-inflammatory diet: Eating a balanced diet rich in protein, fruits and vegetables may help with PsA symptoms. You may benefit from avoiding processed foods, dairy, sugar, and red meat. Exercise: Low- or no-impact exercises such as walking and swimming can help you stay physically active without placing too much demand on painful joints. Identify triggers: Certain foods, activities, and stress can trigger PsA flares. Keeping a symptom journal can help you identify your triggers and avoid them. Maintain a healthy weight: Staying within a healthy weight range helps reduce stress on your joints. Reduce stress: Stress can trigger PsA flares. Manage your stress levels by finding time to relax each day. Quit smoking: Smoking can worsen symptoms and may interfere with your body’s response to medication.
Many people with PsA turn to CAM options to help reduce symptoms. Consult with your healthcare provider before seeking out CAM options. There are many different alternative therapies to consider to complement your traditional treatment, including:
Acupuncture: A traditional Chinese medicine practice, acupuncture uses thin needles to promote the flow of energy in the body. Acupuncture may promote the release of endorphins to help reduce pain. Massage: Getting a massage may help decrease pain and stiffness. Mind-body techniques: Meditation, tai chi, breathwork, and yoga may help you relax and better cope with the physical and emotional aspects of PsA. These techniques can help with stress reduction and promote inner wellness.
Future Approaches to Finding a Psoriatic Arthritis Cure
Psoriatic arthritis research is constantly evolving, and new medications and therapies that show promise for reducing symptoms and disease activity are currently being studied. In order to develop a cure, scientists must first understand the underlying causes of PsA. As more treatments become available, the medical community can fine-tune approaches to treatment, creating a treatment plan for every person with PsA.
While there is not yet a cure for PsA, continued research and advancements are paving the way for more effective treatments. Research is helping healthcare providers better understand the causes and mechanisms that lead to PsA, offering promise for a cure in the future.
Summary
Psoriatic arthritis is a chronic autoimmune disease that does not yet have a cure but can be successfully treated. The causes of PsA have not yet been identified, but genetics, lifestyle, and the immune system are all believed to play a role.
Treatment of PsA may involve medication, lifestyle changes, and complementary therapies. A combination of these can help manage symptoms, control disease progression, and improve your quality of life. Researchers continue to explore potential treatments for PsA, and there is hope that a cure will be discovered in the future.
A Word From Verywell
If you have psoriatic arthritis, it’s important to get diagnosed and treated early in order to keep the disease from progressing. Biologics and DMARDs are the current standard treatments for PsA, and researchers are studying potentially new treatments to reduce symptoms and limit disease activity.
While researchers still have a long way to do to develop a cure, discoveries are happening all the time, and there is hope for a cure in the future. For now, it’s important to focus on taking medications that can help ease your symptoms and improve your quality of life.
