Psoriatic arthritis is a type of inflammatory arthritis that can affect a person’s joints. If the person does not receive treatment, the condition can damage the joints over time.
Psoriatic arthritis can range in severity from mild to severe. A person can often manage mild symptoms with oral medications and lifestyle changes. If psoriatic arthritis becomes moderate or severe, the person may be a good candidate for injectable medications.
While injectable medications can help relieve symptoms and prevent joint damage, this type of treatment may not be the best choice for everyone.
Keep reading to learn more about injectable medications for psoriatic arthritis.
A doctor might recommend injectable treatments if a person:
- has moderate to severe psoriatic arthritis
- has moderate to severe plaque psoriasis, as well as psoriatic arthritis
- has not responded well to other psoriatic arthritis treatments
- does not have an active infection or compromised immune system
To learn whether injectable medications may be a good option, a person should talk to their doctor.
Several injectable drugs can treat psoriatic arthritis. Most belong to a group of medications known as biologics.
As the National Psoriasis Foundation explain, biologics are created from living cells in a laboratory. They target specific cells or proteins in the immune system, such as:
- T cells
- tumor necrosis factor-alpha, or TNF-alpha
- interleukin-17, or IL-17
- interleukin-12, or IL-12
- interleukin-23, or IL-23
The Food and Drug Administration (FDA) have approved the following nine biologics for the treatment of moderate to severe psoriatic arthritis:
- abatacept (Orencia)
- adalimumab (Humira)
- certolizumab pegol (Cimzia)
- etanercept (Enbrel)
- golimumab (Simponi, Simponi Aria)
- infliximab (Remicade)
- ixekizumab (Taltz)
- secukinumab (Cosentyx)
- ustekinumab (Stelara)
A doctor may also prescribe injectable corticosteroids to treat the condition. Corticosteroids are not biologics.
Anyone interested in this treatment should speak with their doctor, who can provide specific information about the risks and potential benefits of the various injectable medications.
A healthcare provider administers Remicade or Simponi Aria via intravenous (IV) infusion. This involves inserting a small needle into the person’s vein. The needle is connected to a tube, through which the medication enters the body.
Cimzia, Enbrel, Simponi, Taltz, Cosentyx, Humira, and Stelara enter the body via subcutaneous injection. This involves using a small needle to inject the medication under the skin. The person can self-administer the injection.
Orencia is available as either an IV infusion or subcutaneous injection.
To administer injectable corticosteroids, a healthcare provider injects the medication directly into an affected joint. This is known as an intra-articular injection.
Treating psoriatic arthritis with injectable medications requires more than one injection.
The right frequency of injections depends on the type of medication. A healthcare provider may recommend multiple injections a week or fewer than one injection a month.
In many cases, a person will have more frequent injections when they start taking a medication, and they will eventually need these injections less frequently.
Injectable medications do not cure the underlying cause of psoriatic arthritis. Even if symptoms of the condition improve, a person will need to continue this treatment on an ongoing basis.
A doctor can provide specific information about how often to receive injections, depending on the drug.
There are risks in receiving injections for psoriatic arthritis. The specific risks can vary, depending on the medication.
Some common side effects of injectable biologics include:
- upset stomach
- abdominal pain
- increased risk of infections, such as upper respiratory infections or hepatitis
After an injection, pain, bruising, swelling, redness, or itching may develop around the injection site. This is known as an injection site reaction.
In rare cases, more serious side effects develop.
Anyone thinking about using injectable medication should talk to their doctor about the risks.
Before prescribing an injectable medication, the doctor usually screens for certain infections. This may involve sending blood samples for testing.
The tests will check for:
- other bacterial or fungal infections
If a person takes injectable medications for psoriatic arthritis, they need to attend regular checkups. These allow the doctor to screen for infections and other possible adverse effects of the treatment.
Before they prescribe injectable medications, doctors often recommend other types of treatment. In some cases, they prescribe injectable medications in combination with some of these treatments.
The Arthritis Foundation describe the range of other psoriatic arthritis treatments, which includes:
- nonsteroidal anti-inflammatory drugs — NSAIDs — such as ibuprofen and naproxen sodium
- traditional disease-modifying antirheumatic drugs — DMARDs — such as methotrexate
- short courses of oral corticosteroids
- physical or occupational therapy
- low-impact exercises
In some cases, a person may also need to support an affected joint with a splint or brace.
In rare cases, a doctor may recommend joint surgery.
Doctors often prescribe injectable medications as a second-line psoriatic arthritis treatment — when other treatments have not been effective.
Receiving these injections can increase a person’s risk of infection. Anyone who has an active infection or compromised immune system should not use this type of treatment.
Anyone with psoriatic arthritis who wonders whether injectable medications are suitable should discuss the risks and potential benefits with a doctor.