Treatments for Psoriatic Arthritis
Treatments for Psoriatic Arthritis
The list of treatments mentioned in various sources
for Psoriatic Arthritis
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
- Treatments are directed at reducing and controlling inflammation. NSAIDs such as diclofenac and naproxen are usually the first line medication
- Other treatment options for this disease include joint injections with corticosteroids
- Immunosuppressants such as methotrexate or leflunomide
- Tumor necrosis factor-alpha inhibitors
Psoriatic Arthritis: Is the Diagnosis Correct?
The first step in getting correct treatment is
to get a correct diagnosis.
Differential diagnosis list for Psoriatic Arthritis may include:
Hidden causes of Psoriatic Arthritis may be incorrectly diagnosed:
Psoriatic Arthritis: Marketplace Products, Discounts & Offers
Products, offers and promotion categories available for Psoriatic Arthritis:
Psoriatic Arthritis: Research Doctors & Specialists
- Bone, Joint and Orthopedic Specialists:
- Immune-Related Disease Specialists (Immunology):
- Arthritis & Joint Health Specialists (Rheumatology):
- more specialists...»
Research all specialists including ratings, affiliations, and sanctions.
Drugs and Medications used to treat Psoriatic Arthritis:
Note:You must always seek professional medical advice about any prescription drug, OTC drug, medication, treatment
or change in treatment plans.
Some of the different medications used in the treatment of Psoriatic Arthritis include:
Hospital statistics for Psoriatic Arthritis:
These medical statistics relate to hospitals, hospitalization and Psoriatic Arthritis:
- 0.0001% (13) of hospital consultant episodes were for psoriatic and enteropathic arthropathies in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 92% of hospital consultant episodes for psoriatic and enteropathic arthropathies required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 62% of hospital consultant episodes for psoriatic and enteropathic arthropathies were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 38% of hospital consultant episodes for psoriatic and enteropathic arthropathies were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 17% of hospital consultant episodes for psoriatic and enteropathic arthropathies required emergency hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- more hospital information...»
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Book Excerpts: Treatment of Psoriatic Arthritis
Treatments of Psoriatic Arthritis: Online Medical Books
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Arthritis – Single Joint:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
If septic arthritis is a possibility, broad-spectrum antibiotic treatment should be started immediately
-
Fractures and most internal derangements require orthopedics involvement
-
Appropriate referral and treatment for malignancy
-
JRA and SpA are usually treated with NSAIDs initially, DMARDs (e.g., sulfasalazine and methotrexate) and biologics (e.g., TNF blockers) are added depending on the degree of inflammation and the response of individual patient
-
Supportive therapy such as PT and OT to increase range of motion and strength; insoles to correct leg length discrepancy
-
Psychosocial support, especially with chronic arthritis
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Osteoarthritis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment is aimed at relieving pain, maintaining or improving mobility, and minimizing disability. Medications include nonsteroidal anti-inflammatory drugs, Cox-2 inhibitors and, in some cases, intra-articular injections of corticosteroids. Studies indicate that glucosamine and chondroitin may be useful in controlling symptoms and reducing functional impairment. Injecting artificial joint fluid into the knee can provide relief of pain for up to 6 months.
Effective treatment also reduces stress by weight loss and supporting or stabilizing the joint with crutches, braces, cane, walker, cervical collar, or traction. Exercise, such as through physical therapy, is integral to maintaining or improving joint mobility. Other supportive measures include massage, moist heat, paraffin dips for hands, protective techniques to prevent undue stress on the joints, and adequate rest (particularly after activity).
Surgical treatment, such as one of the following, is reserved for patients who have severe disability or uncontrollable pain:
❑ Arthroplasty (partial or total): replacement of deteriorated part of joint with prosthetic appliance
❑ Arthrodesis: surgical fusion of bones, used primarily in spine (laminectomy)
❑ Osteoplasty: scraping and lavage of deteriorated bone from joint
❑ Osteotomy: change in alignment of bone to relieve stress by excision of wedge of bone or cutting of bone.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Psoriatic arthritis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
In mild psoriatic arthritis, treatment is supportive and consists of immobilization through bed rest or splints, isometric exercises, paraffin baths, heat therapy, and aspirin and other nonsteroidal anti-inflammatory drugs. Some patients respond well to low-dose systemic corticosteroids; topical steroids may help control skin lesions. Gold salts and, most commonly, methotrexate therapy are effective in treating both the articular and cutaneous effects of psoriatic arthritis. Antimalarials are contraindicated because they can provoke exfoliative dermatitis.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Septic arthritis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Antibiotic therapy should begin as soon as a Gram stain has been done; it may be modified when drug sensitivity of the infecting organism is known. Bioassays or bactericidal assays of synovial fluid and bioassays of blood may confirm clearing of the infection.
Rest, immobilization, elevation, and warm compresses help with pain relief. Analgesics are given for pain, if needed. The affected joint can be immobilized with a splint or put into traction until the patient can tolerate movement.
In severe cases, needle aspiration (arthrocentesis) or surgery may be done under sterile conditions to remove grossly purulent or infected joint fluid. Late reconstructive surgery is warranted only for severe joint damage and only after all signs of active infection have disappeared, which usually takes several months. Recommended procedures include arthroplasty and joint fusion. Prosthetic replacement remains controversial because it may exacerbate the infection, but it has helped patients with damaged femoral heads or acetabula.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Psoriasis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment depends on the type of psoriasis, the extent of the disease and the patient’s response to it, and what effect the disease has on the patient’s lifestyle. No permanent cure exists, and all methods of treatment are merely palliative. Ideally, all patients should see a dermatologist at least once.
Removal of psoriatic scales necessitates application of occlusive ointment bases, such as petroleum jelly, salicylic acid preparations, or preparations containing urea. Baker P & S liquid (phenol, sodium chloride, and liquid paraffin), applied to the scalp at bedtime, or liquid carbonis detergens in Nivea oil applied for 6 to 8 hours, is also effective. Shampoo or tar-based preparations are also used. These medications soften the scales, which can then be removed by scrubbing them carefully with a soft brush while bathing. Some preparations, such as tar-based preparations, can be used in whirlpools for extensively involved areas.
Methods to retard rapid cell production include exposure to ultraviolet light (UVB or natural sunlight) to the point of minimal erythema. Tar preparations or crude coal tar itself may be applied to affected areas about 15 minutes before exposure or may be left on overnight and wiped off the next morning. A thin layer of petroleum jelly may be applied before UVB exposure (the most common treatment for generalized psoriasis). Exposure time can increase gradually. Outpatient or day treatment with UVB prevents long hospitalizations and prolongs remission.
Steroid creams and ointments are useful to control psoriasis. A potent fluorinated steroid works well, except on the face and intertriginous areas. These creams require application twice daily, preferably after bathing to facilitate absorption, and overnight use of occlusive dressings, such as plastic wrap, plastic gloves or booties, or a vinyl exercise suit (under direct medical or nursing supervision). Small, stubborn plaques may require intralesional steroid injections. Anthralin, combined with a paste mixture, may be used for well-defined plaques but must not be applied to unaffected areas because it causes injury and stains normal skin. Apply petroleum jelly around the affected skin before applying anthralin. Commonly used concurrently with steroids, anthralin is applied at night and steroids during the day.
In a patient with severe chronic psoriasis, the Goeckerman regimen — which combines tar baths and UVB treatments — may help achieve the longest remission and clear the skin in 3 to 5 weeks. The Ingram technique is a variation of this treatment, using anthralin instead of tar. A therapy called PUVA combines administration of psoralens with exposure to high-intensity UVA. As a last resort, a cytotoxin, usually methotrexate or cyclosporine, an immunosuppressant, may help severe, refractory psoriasis.
Etretinate, a retinoid compound, is effective in treating extensive cases of psoriasis. However, because this drug is a strong teratogen, it’s unsafe for use in women of childbearing age. It also has numerous adverse effects that many patients find intolerable. Tacarotene, a newer topical retinoid, combined with a medium-strength topical corticosteroid is also effective.
Low-dose antihistamines, oatmeal baths, emollients, and open wet dressings may help relieve pruritus. Aspirin and local heat help alleviate the pain of psoriatic arthritis; severe cases may require nonsteroidal anti-inflammatory drugs.
Therapy for psoriasis of the scalp consists of a tar shampoo followed by application of a steroid lotion; ketoconazole and anthralin may also be effective. No effective treatment exists for psoriasis of the nails.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Osteoarthritis:
Treatment
(Handbook of Diseases)
The goal of treatment is to relieve pain, maintain or improve mobility, and minimize disability. Medications include various nonsteroidal, antiinflammatory drugs (NSAIDs).
UNDER STUDY: COX-2 inhibitors, such as celecoxib, rofecoxiob, and valdecoxib are part of a new class of drugs that have the anti-inflammatory effects of NSAIDS but produce less stomach irritation. Many patients also benefit from such over-the-counter remedies as glucosamine and chondroitin sulfate. However, although many agents are helpful in controlling pain, they don’t appear to stimulate growth of new cartilage.
In some cases, intra-articular injections of corticosteroids given every 4 to 6 months are used to reduce inflammation and pain. Artificial joint fluid, such as Synvisc and Hyalgan, can also be injected into the knee and can result in temporary relief of pain for up to 6 months.
Usually, a 2-week trial period is needed to evaluate the benefit of a particular medication.
Effective treatment also reduces stress by supporting or stabilizing the joint with crutches, braces, cane, walker, cervical collar, or traction. Other supportive measures include massage, moist heat, paraffin dips for hands, protective techniques for preventing undue stress on the joints, adequate rest (particularly after activity) and, occasionally, exercise when the knees are affected.
Surgical treatment, reserved for patients who have severe disability or uncontrollable pain, may include the following:
❑ arthroplasty (partial or total): replacement of the deteriorated part of the joint with a prosthetic appliance
❑ arthrodesis: surgical fusion of bones; used primarily in the spine (laminectomy)
❑ osteoplasty: scraping and lavage of deteriorated bone from the joint
❑ osteotomy: change in alignment of the bone to relieve stress by excision of a wedge of bone or cutting of bone.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Psoriatic arthritis:
Treatment
(Handbook of Diseases)
In mild psoriatic arthritis, treatment is supportive and consists of immobilization through joint rest or splints, isometric exercises, paraffin baths, heat therapy, and aspirin and other non-steroidal anti-inflammatory drugs. Some patients respond well to low-dose systemic corticosteroids; topical steroids may help control skin lesions. More severe arthritis requires treatment with more powerful drugs called disease-modifying antirheumatic drugs.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Septic arthritis:
Treatment
(Handbook of Diseases)
The goals of treatment are to provide oxygen and to treat respiratory distress, if present; to monitor and reverse shock through volume expansion; to treat underlying infections with antibiotic therapy; and to support poorly functioning organs.
Treatment begins with the administration of I.V. fluids and the insertion of a pulmonary artery catheter to check pulmonary circulation and PAWP. Administration of whole blood or plasma may be necessary to help raise the PAWP to a satisfactory level of 14 to 18 mm Hg. A urinary catheter allows accurate measurement of hourly urine output.
The patient may require endotracheal intubation and placement on a ventilator to overcome hypoxia. Adjustments are necessary to promote adequate cellular oxygenation and support hyperdynamic needs.
Antibiotic therapy
Treatment also requires immediate administration of I.V. antibiotics to control the infection. Depending on the organism, an antibiotic combination may be necessary.
Appropriate anti-infectives for causes of septic shock depend on the suspected organism. Other measures to combat infections include surgery to drain and excise abscesses and debridement.
Other drug therapy
If shock persists after fluid infusion, treatment with a vasopressor, such as dopamine, maintains adequate blood perfusion to vital organs. Other treatment includes correction of acidosis and, possibly, I.V. corticosteroids.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Psoriasis:
Treatment
(Handbook of Diseases)
Appropriate treatment depends on the type of psoriasis, the extent of the disease and the patient’s response to it, and the effect the disease has on the patient’s lifestyle. No permanent cure exists, and all methods of treatment are palliative.
UVB exposure
Methods to retard rapid cell production include exposure to ultraviolet (UV) light (UVB or natural sunlight) to the point of minimal erythema. Tar preparations or crude coal tar itself may be applied to affected areas about 15 minutes before exposure or may be left on overnight and wiped off the next morning.
A thin layer of petroleum jelly may be applied before UVB exposure (the most common treatment for generalized psoriasis). Exposure time can increase gradually. Outpatient or day treatment with UVB prevents long hospitalizations and prolongs remission.
Drug therapy
Steroid creams and ointments are useful to control psoriasis. A potent fluorinated steroid works well, except on the face and intertriginous areas. These creams require application two times a day, preferably after bathing to facilitate absorption, and the overnight use of occlusive dressings, such as plastic wrap, plastic gloves or booties, or a vinyl exercise suit (under direct medical or nursing supervision).
Small, stubborn plaques may require intralesional steroid injections. Anthralin ointment or paste mixture may be used for well-defined plaques but must not be applied to unaffected areas because it causes injury and stains normal skin. Apply petroleum jelly around the affected skin before applying anthralin. Typically used with steroids, anthralin is applied at night and steroids during the day. A new topical agent is calcipotriene ointment, a vitamin D3 analogue.
CLINICAL TIP: Calcipotriene treatment also works best when alternated with a topical steroid, as noted above with anthralin.
Other treatments
Low-dose antihistamines, oatmeal baths, emollients, and open wet dressings may help relieve pruritus. Aspirin and local heat help alleviate the pain of psoriatic arthritis; severe cases may require nonsteroidal anti-inflammatory drugs.
Therapy for psoriasis of the scalp consists of a tar shampoo followed by application of a steroid lotion. No effective topical treatment exists for psoriasis of the nails.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
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