An Overview of Psoriatic Arthritis Treatment Injections

From verywellhealth.com

Psoriatic arthritis treatments can vary depending on the range and severity of symptoms that you may experience. When people with psoriatic arthritis begin to experience moderate or severe symptoms and do not respond well to other treatments, psoriatic arthritis injections are available.

In this article, we'll discuss psoriatic arthritis injections and symptoms of the condition.

What Are Biologic Psoriatic Arthritis Treatments?

Commonly prescribed medications for psoriatic arthritis include nonsteroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs) like methotrexate. They can help reduce inflammation and related symptoms. If these medications fail to improve symptoms, biologic medications are usually recommended next.

Biologics are a class of drugs that suppress targeted areas of your immune system to reduce inflammation in autoimmune diseases, where your immune system mistakenly attacks healthy cells. Tumour necrosis factor and other cytokines like interleukin 12, 17, and 23, cell-signalling proteins produced by the immune system that cause inflammation, are abnormally elevated in patients with psoriatic arthritis. Biologic medications target these cytokines to reduce inflammation throughout the body. 

Small molecules such as Janus kinase (JAK) inhibitors and phosphodiesterase 4 inhibitors, like Otezla (apremilast) are also used to treat psoriatic arthritis. They both inhibit certain enzymes associated with inflammation. Xeljanz (tofacitinib) is the only type of JAK inhibitor approved by the U.S. Food and Drug Administration (FDA) to treat psoriatic arthritis.

Psoriatic Arthritis Treatment Injection Options

There are several different kinds of biologic injections used to treat psoriatic arthritis. These include:

• Cimzia (certolizumab pegol)
• Cosentyx (secukinumab)
• Enbrel (etanercept)
• Humira (adalimumab)
• Remicade (infliximab)
• Simponi (golimumab)
• Skyrizi (risankizumab)
• Stelara (ustekinumab)
• Taltz (ixekizumab)

There are additional forms of biologic injections available, but they are typically only used for the treatment of psoriasis and not psoriatic arthritis. These include:

• Ilumya (tildrakizumab)
• Tremfya (guselkumab)

The frequency of injections will depend on the specific type of medication that you are prescribed. Remicade is delivered intravenously (IV) at a hospital, infusion center, or another medical facility, and repeated every eight weeks.

All the other types of medication are injected subcutaneously, or under the skin, in your abdomen or thigh. Many of these injections can be done by yourself at home. Some medications require a frequent injection schedule, such as Enbrel, which has to be done every week, and Cimzia every other week.

Other medications require less frequent injections after initial doses, such as Cosentyx, Taltz, and Simponi and Skyrizi and Stelara every 12 weeks.

Risks of Biologic Psoriatic Arthritis Treatment

Because biologic medication weakens your immune system, it can also increase your risk of getting an infection or reactivating a prior infection such as hepatitis B or tuberculosis.

There is always a possibility of having an allergic reaction when taking medication. If you experience shortness of breath, fever, chills, numbness, tingling, rash, or redness, itchiness, or pain at the injection site, contact your doctor immediately since these are possible signs of an allergic reaction.

The most common adverse effects from biologic injections include pain, swelling, itching, rash, and redness at the injection site. If you have any of these symptoms, talk to your doctor about switching your medication.

Steps to Self-Inject Treatment

Remove your prefilled syringe from the refrigerator 30 minutes before the time you are going to administer your injection so the medication can reach room temperature.

Before administering your injection, you should have an alcohol pad and sterile bandage ready. Wash your hands with soap and water before using an alcohol pad to cleanse the area where you will administer the injection.

Twist off the cap to expose the needle. You should pinch the skin of your abdomen or thigh where you will deliver the injection and quickly insert the needle at a 90-degree angle. Once the needle is inserted, slightly pull back on the syringe, then push the plunger to inject the medication.

Once all the medication in the syringe is injected, remove the needle from your skin. Hold the alcohol pad over the injection site and apply a bandage to the area if it bleeds. Replace the cap onto the needle and dispose of it in the garbage.

Sometimes an auto-injector is used instead of a prefilled syringe. Follow the same storage and preparation instructions above. Then twist off the needle cap and place the base of the auto-injector against the skin on your abdomen or thigh. Turn the lock ring to unlock the device and press the injection button. A needle will automatically lower into your skin to deliver the injection.

Used sharps should be immediately placed in a sharps disposal container. FDA-cleared sharps containers are generally available through pharmacies, medical supply companies, healthcare providers and online. These containers are made of puncture-resistant plastic with leak-resistant sides and bottom.

Managing Psoriatic Arthritis

Management of psoriatic arthritis is crucial to slowing disease progression and preventing flare-ups, which can significantly affect your joint mobility and your ability to complete day-to-day activities. Because psoriatic arthritis is an autoimmune disease, taking your medication as prescribed by your doctor is key to reducing inflammation. 

Other treatment options to help manage symptoms of psoriatic arthritis include:

• Rest: Limiting activity and avoiding repetitive movements can help ease pain and inflammation.
• Ice: Applying ice to your joints can help relieve pain and inflammation, especially if swelling is present.
• Exercise: Certain stretches and exercises can help ease pain, improve range of motion and joint mobility, and increase the strength of the muscles surrounding your joints.
• Rehabilitation: Your doctor may refer you to physical or occupational therapy to improve your joint mobility, and increase the strength and flexibility of surrounding muscles. These healthcare professionals will also apply therapeutic modalities to alleviate joint pain, stiffness, and swelling.
• Lifestyle habits: Healthy habits performed daily such as eating a balanced diet, getting enough sleep, exercising regularly, and effectively managing stress can help decrease inflammation throughout the body. 

Summary

Psoriatic arthritis is treated with nonsteroidal anti-inflammatory drugs (NSAIDs) to help with pain and inflammation and disease-modifying antirheumatic drugs like methotrexate to slow disease progression. If you don't respond well to DMARDs, biologics are usually prescribed to help with the condition. There are different types of biologic injections to treat psoriatic arthritis. Several of these medications can be self-injected safely at home and require storage in the refrigerator before use. When administering self-injections, it's important to keep your hands and the injection site clean to prevent infections.

A Word From Verywell

Biologic injections are a treatment option to help manage psoriatic arthritis that has been unresponsive to other treatment methods. If you have not seen any improvement in symptoms with other types of medications or lifestyle changes, talk to your doctor about the possibility of trying a biologic injection. Psoriatic arthritis is a progressive condition without a cure that can cause permanent joint damage and disability if left untreated. Most people will experience some improvement in symptoms of psoriatic arthritis after starting biologic injections. 

https://www.verywellhealth.com/psoriatic-arthritis-treatment-injections-5198679