Can You Prevent Psoriatic Arthritis?

From healthcentral.com

Answer: No, but there are ways to lower risk factors and keep moderate PsA from becoming severe. Here’s how 

For right now, psoriatic arthritis (PsA) is not a preventable disease. Whether or not you develop psoriatic arthritis is determined by a combination of genetics, environment, and lifestyle factors. Scientists are continuously learning how these variables fit together to cause this chronic condition.

Still, that doesn’t mean that you are totally powerless in your psoriatic arthritis journey. Just the opposite, in fact: When it comes to symptom management and disease severity, much is within your control. Follow the expert- and science-backed advice here to help make psoriatic arthritis easier to navigate and less disruptive in your daily life.

Preventing Psoriatic Arthritis Symptom Flares

While we can’t yet prevent PsA, there are treatments and strategies to keep it under control. Psoriatic disease often goes through cycles of active symptoms that appear for a few weeks or months and then subside. These are called flares or psoriatic arthritis flare-ups.

The source of what made the flare occur in the first place is referred to as a trigger. If you want to reduce your flares, you need to determine the triggers that seem to exacerbate your condition, says Waseem Mir, M.D., a rheumatologist at Lenox Hill Hospital in New York City. That’s not always easy. “Different people with PsA have different triggers,” Dr. Mir says. “For example, emotional stress, food intolerances, and changes in weather can cause psoriatic arthritis to flare.” Per Dr. Mir, some of the other known PsA triggers include:

• Alcohol

• Lack of Sleep

• Medications such as beta-blockers

• Obesity

• Poor Diet

• Skipping or stopping psoriatic arthritis medication

• Smoking

• Stress

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Treatment for Psoriatic Arthritis

Treatment for PsA is definitely not a one size fits all proposition. And more often than not, finding the best treatment for you is a process of trial and error, especially if your rheumatologist is attempting to treat psoriasis and PsA at the same time. The American College of Rheumatology and the National Psoriasis Foundation have issued guidelines for PsA treatment. Both nonpharmacologic and pharmacologic treatment are recommended. Non-pharmacological therapies include:

• Exercise

• Massage therapy

• Physical therapy

• Occupational therapy

• Smoking cessation

• Weight loss

There are wide variety of pharmacological treatments for PsA, depending on symptom severity and include:

• Nonsteroidal anti-inflammatory medications (NSAIDs)

• Glucocorticoids

• Disease-modifying antirheumatic drugs (DMARDs)

• Tumour necrosis factor inhibitors

• Biologics

• Janus kinase (JAK) inhibitors

Role of Psoriasis in Psoriatic Arthritis Prevention

Having said that there is no known way to prevent PsA, it’s also true that scientists have some hunches. For example, we know there is a strong relationship between psoriasis and psoriatic arthritis, and that the severity of psoriasis may be one prediction of whether or not a person develops PsA.

Approximately 20% to 30% of those with psoriasis develop psoriatic arthritis, although the reason why is still a mystery. “The events responsible for progression from psoriasis to psoriatic arthritis are currently unclear,” says Zhanna Mikulik, M.D., a rheumatologist who leads the psoriatic arthritis clinic at The Ohio State University Wexner Medical Centre in Columbus. “But psoriasis severity and nail pitting are predictors of PsA development.”

Can treating psoriasis prevent PsA? That’s a question currently being investigated, acknowledges Dr. Mikulik. “Several studies are underway to evaluate whether highly effective treatment of psoriasis can prevent or mitigate development of PsA,” she says. (In case you’re wondering, it’s also possible to have psoriatic arthritis without having psoriasis, but it is not very common.)

Can Weight Loss Prevent Severe Psoriatic Arthritis Symptoms?

Losing weight if you’re carrying extra pounds won’t prevent or cure you of psoriatic arthritis, but it can make the joint pain associated with the disease easier to bear. “Obesity is associated with higher disease activity in psoriatic arthritis,” says Dr. Mikulik. The connection: Body fat may promote chronic low-grade inflammation, per research in the journal Rheumatology and Therapy. And inflammation is at the heart of PsA pain.

Shedding pounds is never an easy feat, but even a small amount of weight loss can make a major difference in disease activity, believes Dr. Mikulik. Bonus: The same foods that promote weight loss can also fight inflammation, including anti-inflammatory foods such as olive oil, leafy greens, fatty fish, fruits and berries, and nuts.

Beyond reducing inflammation, weight loss can also improve the efficacy of your psoriatic arthritis medication. According to a 2020 article, obesity is associated with lessening the potency of PsA medication, especially when it comes to anti-tumour necrosis factor (TNF) agents.

Controlling Psoriatic Arthritis Can Help Prevent Other Diseases

According to the Arthritis Foundation, more than half of people with PsA have at least one other related medical condition and 40% of people with PsA have three or more comorbid conditions. One of the big ones? Heart disease. “Psoriatic disease should be controlled to lower the risk of developing heart disease,” maintains Dr. Mikulik, who explains that lifestyle changes such as a healthy diet, regular exercise, smoking cessation, and weight loss can all be helpful to reducing PsA co-morbidities.

Emotional Toll of Psoriatic Arthritis

If you have psoriatic arthritis, you know all about the emotional toll this disease can take. “Living with pain can be depressing,” says Dr. Mir. “The limitations of what you can do, and if your joints are going to agree with it, can also take its toll.”

In a 2022 study looking at psoriatic arthritis and mental health, PsA was associated with depression and higher anxiety. According to the study authors, depression remains unrecognized and untreated in over half of moderately-to-severe psoriasis patients. Fortunately, there are things you can do to care for your mental health while managing psoriatic arthritis. First, talk to your doctor about feelings of anxiety or depression. “Some patients will let you into what they are experiencing, while others will cover it up,” says Dr. Mir. Staying on top of your psoriatic arthritis treatment to minimize flares can also help you mentally. Joint pain along with stiffness and reduced range of motion can be mentally wearing.

And finally, connecting with others living with psoriatic arthritis can help you feel understood, especially when it comes to grappling with the uneven nature of the condition. Staying physically active and eating well are two other tools to help keep your mood steady when you’re dealing with PsA. There’s nothing easy about living with a disease that can neither be prevented nor cured, but with the right approach, you can learn to manage symptoms and maintain your quality of life.

https://www.healthcentral.com/condition/psoriatic-arthritis/can-you-prevent-psoriatic-arthritis