Psoriatic Arthritis: Will There Be a Cure Soon?

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Psoriatic arthritis (PsA) is a chronic disease that—at least for now—has no cure.

Treatments are getting better, though. And the more researchers learn about PsA, the more likely it becomes that you could see a psoriatic arthritis cure.

This article will look at PsA, its causes, treatment goals and the likelihood of a cure, as well as how you can cope with this disease.

Patches of psoriasis exist on a woman's knee and elbow.

Natalia SERDYUK / Getty Images

What Is Psoriatic Arthritis?

Psoriatic arthritis is an inflammatory disease related to psoriasis, which is an autoimmune disease. About 85% of the people with PsA had psoriasis first.

In psoriasis, the immune system mistakenly attacks healthy skin cells as if they were a threat, like a virus or bacterium. That causes damage and inflammation.

On light skin, psoriasis looks red and scaly. On darker skin, the patches are darker and thicker.

In about 30% of cases, inflammation eventually “spills over” and affects you in different ways. The result is PsA, with symptoms such as:

  • Joint pain with heat, redness, and swelling
  • Stiffness
  • “Sausage-like” fingers and toes
  • Deformed nails
  • Fatigue
  • Eye pain and redness
  • Plaques (silvery-white patches on the skin) 

Plaques are most common on the scalp, elbows, knees, genitals, and lower back.

Recap

Psoriatic arthritis is a chronic disease with no cure. It develops as a consequence of the autoimmune skin disease psoriasis. Inflammation from psoriasis spreads to joints and other areas, leading to pain, stiffness, plaques on the skin, and other symptoms.

Causes

The causes of autoimmune disease aren’t yet understood. Researchers believe many factors contribute to psoriasis and PsA’s development, including:

  • Genetic differences, most of which relate to the immune system
  • A flawed immune system
  • Lifestyle

Lifestyle risk factors include:

Highly Inheritable

The genetic component of PsA is greater than that of many other autoimmune diseases. About 40% of people with PsA have one or more close family members with it.


Treatment Goals

The goals of treatment for PsA are to manage symptoms, improve or maintain your quality of life, and prevent structural damage.

With successful treatment, some people with PsA go into remission. That means their symptoms are extremely light or non-existent. 

However, it’s not a cure, and symptoms could someday return. Many treatment options are available.

Topicals: Ointments and Creams

Over-the-counter (OTC) creams containing 1% hydrocortisone can help with itching. But most people with PsA need prescription creams and ointments. These can include:

  • Topical corticosteroids: Short-term use only; eases itching, inflammation; Cordran (flurandrenolide), Topicort (desoximetasone)
  • Synthetic vitamin D: Slows skin growth; watch for irritation; Dovonex (calcipotriene), Vectical (calcitriol)
  • Dritho-Scalp (anthralin): Slows skin growth, removes scales, smooths skin; watch for irritation
  • Retinoids: May decrease inflammation; watch for irritation, sensitivity to sunlight; Tazorac/Avage (tazarotene)
  • Calcineurin inhibitors: Decreases inflammation, plaque buildup; long-term or continuous use may increase skin cancer risk; Prograf (tacrolimus), Elidel (pimecrolimus)

Anti-Inflammatories

Nonsteroidal anti-inflammatory drugs are usually the first medication recommended for mild cases of PsA. OTC NSAIDs include:

Stronger NSAIDs are available by prescription. These include:

Steroids: Oral or Injectable

These powerful inflammation fighters are treatments for flares. Some common ones are:

Opioids

Opioids, also called narcotics, are strong painkillers. Because they’re addictive, they should be reserved for short-term use of severe pain. Examples are:

Anti-Rheumatic Drugs

Drugs aimed at slowing autoimmune activity are called disease-modifying anti-rheumatic drugs (DMARDs). They’re also called immunosuppressants. Some come in pill form and some are injectable or an infusion.

Several kinds are available:

Surgeries

In rare cases where joint damage becomes severe, surgery may become necessary. However, it’s considered a last resort.

Different types are:

  • Joint fusion: Limits mobility, but can relieve pain
  • Synovectomy: Partial or total removal of the joint lining
  • Joint replacement: Partial or total removal of a joint (usually large joints like hips and knees)

Fewer than 10% of PsA cases ever require surgery.

Progress Toward a Cure

Each new treatment represents research and gained knowledge about what psoriasis and PsA do to your body. That helps get medical science closer to understanding the underlying causes and mechanisms.

Eventually, that understanding could lead to better diagnostics, better treatments, preventive measures, and possibly even a cure.

For now, though, successful treatment and remission are the goals to strive for.

Early Detection and Treatment

Early detection and treatment are important for preventing psoriatic arthritis from progressing and causing significant joint damage and disability. Ongoing research is aimed at finding biomarkers that will allow healthcare providers to diagnose PsA earlier.

Coping

Adopting healthy lifestyle changes can help you combat symptoms and cope better with psoriatic arthritis. These include: 

  • Anti-inflammatory diet: You may especially benefit from avoiding fatty red meat, dairy, and sugar.
  • Regular exercise: Talk to your healthcare provider about what kind of exercise is right for you and what may be harmful.
  • Rest your joints: Use your joints as little as possible during flares. Stressing joints during flares can cause permanent damage. Braces or splints may help ease joint stress.
  • A healthy weight: Carrying extra pounds adds stress to your joints. Look for healthy ways to lose or maintain weight.
  • Identify flare triggers: Common triggers include food, strenuous activities, emotional stress, and more. A symptom journal may help you identify patterns.
  • Don’t smoke: Smoking can lead to more severe disease and a weaker response to PsA medications.
  • Treat anxiety and depression: These conditions are common in people with PsA. They can worsen your PsA flares and quality of life.
  • Manage stress: Stress triggers flares in about half of people with PsA. If you need help, consider seeing a therapist.

Everyone is different, so treatment and management strategies need to be designed for you while keeping your total health picture in mind. Work with your healthcare team—which usually includes a rheumatologist and a dermatologist—to establish healthy habits that are effective for you.

Summary

Psoriatic arthritis is a chronic inflammatory disease that’s not yet curable, but can be successfully treated. It’s usually preceded by the autoimmune skin disease psoriasis. Inflammation from psoriasis “spills over” beyond the skin to joints.

The causes of PsA aren’t fully understood. Along with the immune system, genetics and lifestyle factors are believed to play roles. 

Treatment goals include managing symptoms, protecting your quality of life, and preventing joint damage. Prescription and OTC ointments, creams, and medications are available. Rarely, joint surgery may be necessary.

Some day, the knowledge gained from research may lead to better diagnostics and treatments, ways to prevent PsA, and possibly a cure.

In the meantime, lifestyle changes including an anti-inflammatory diet, weight loss, regular exercise, and not smoking can help you cope with PsA.

A Word From Verywell

If you or close family members have psoriasis, you may want to ask your healthcare provider to periodically check for signs of psoriatic arthritis. That way, you can get it diagnosed and treated early, which can keep the disease from progressing.

As for a cure, researchers still have a long way to go, but they’re learning more all the time. You and your healthcare providers can put that knowledge to work now to help ease your symptoms and improve your life.

Frequently Asked Questions

  • What is the best treatment for psoriatic arthritis?

    There’s no single best psoriatic arthritis treatment. The right treatment for you depends on a variety of factors, including how advanced the disease is, your personal response to treatments, and your total health history.

    Treatments with the most evidence behind them include:

    • Nonsteroidal anti-inflammatory drugs (NSAIDs)
    • Corticosteroids (topical or oral)
    • Disease-modifying anti-rheumatic drugs (DMARDs)
    • Biologic drugs
  • How can you relieve pain from psoriatic arthritis?

    Along with medications and topical treatments that your healthcare team can recommend or prescribe, it can help to stay physically active, maintain a healthy weight, lower your stress, and try an anti-inflammatory diet.

    Some evidence also supports acupuncture and mindfulness meditation to relieve pain and stress.

    In addition, you can try home remedies like a hot bath, possibly with Epsom salts, and heat or ice packs on achy joints.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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