Injections for psoriatic arthritis (PsA) may help relieve symptoms and prevent joint damage. However, this type of treatment may not be the best option for everyone.
The best type of injection for PsA will vary from person to person. What works for one individual’s condition may not work for someone else’s condition.
PsA is a type of inflammatory arthritis that can affect a person’s joints. An individual may manage mild symptoms with oral medications and lifestyle changes. If PsA becomes moderate or severe, a healthcare professional may suggest that the person receive injectable medications.
Keep reading to learn more about injections for PsA.
A doctor might recommend injectable treatments if a person:
- has moderate to severe PsA
- has moderate to severe plaque psoriasis, as well as PsA
- has PsA that has not responded well to other 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 with their doctor.
Several injectable drugs can treat PsA. Most belong to a group of medications known as biologics.
As the National Psoriasis Foundation explains, biologics come 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) has approved the following biologics for the treatment of moderate to severe PsA:
- 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 relieve acute, severe joint inflammation and swelling. 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.
Healthcare professionals administer Remicade or Simponi Aria via an intravenous (IV) infusion. This involves inserting a small needle into the person’s vein. The needle connects 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. People can self-administer the injection.
Orencia is available as either an IV infusion or subcutaneous injection. To administer injectable corticosteroids, a healthcare professional injects the medication directly into an affected joint. This is known as an intra-articular injection.
Treating PsA with injectable medications requires more than one injection. The appropriate frequency of injections depends on the type of medication.
In many cases, a person will have more frequent injections when they start taking a medication. They will eventually need these injections less frequently. For example, a person may receive Orencia every 2 weeks initially, but later, they may receive it every 4 weeks. A doctor will adjust the dosage schedule according to each case.
Injectable medications do not cure the underlying cause of PsA. 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.
Receiving injections for PsA does have risks. The specific risks can vary, depending on the medication.
Some potential side effects of injectable biologics include:
- flu-like symptoms
- upper respiratory infections
- urinary tract infections (UTI)
- increased risk of serious infections
After an injection, pain, bruising, swelling, redness, or itching may develop around the injection site. This is known as an injection site reaction.
Sometimes, more serious side effects develop. Certain biologics can also interact with other pre-existing conditions. Anyone thinking about using injectable medication should talk with their doctor about the risks.
Before prescribing an injectable medication, a doctor usually screens for certain infections. This may involve sending blood samples to a lab for testing.
The tests will check for:
If a person takes injectable medications for PsA, they need to attend regular checkups. These allow the doctor to screen for infections and other possible harmful effects of the treatment.
Before they prescribe injectable medications, doctors may recommend other types of treatment for PsA. In some cases, they prescribe injectable medications in combination with some of these treatments.
The Arthritis Foundation describes other PsA treatments, which include:
- nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen
- traditional disease-modifying antirheumatic drugs, such as methotrexate
- short courses of oral corticosteroids
- physical or occupational therapy
- low impact exercise
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 recommend PsA injections when other treatments have not been effective, as a second-line treatment.
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 PsA who wonders whether injectable medications are suitable for their condition should discuss the risks and potential benefits with a doctor.