Antimalarial and Other DMARD Drugs
Antimalarial treatment, commonly used with success in rheumatoid arthritis, has sometimes been used to treat psoriatic arthritis.
Antimalarials are usually given as one or two pills, once a day. It may take many months before seeing benefits. Side effects include vision changes (blurring, halos around lights and sensitivity to light), headache, dizziness, nausea and vomiting. Individuals taking an antimalarial should have eye examinations periodically.
Unless you are directed to do so by your doctor, do not take Plaquenil, the most commonly prescribed antimalarial. The use of Plaquenil may cause a severe flare of psoriasis.
Some antimalarials can cause the skin disease to get worse in some individuals. Talk to your doctor about the available antimalarial treatments and alternatives.
Steroid medications taken by mouth or injection are not generally recommended for long-term treatment of psoriatic arthritis. In some circumstances, they may be needed for relief of acute, severe joint inflammation and swelling. For the most part, large doses of steroids should be avoided. Psoriasis lesions may potentially become worse after the steroid treatment is discontinued.
Severe forms of psoriasis, such as pustular psoriasis, may occasionally be provoked by the use of systemic steroids. However, selective low-dose steroid injections to inflamed joints, tendons and the area around joints can improve range of motion.
Imuran is an immunosuppressive drug approved for use in arthritis. It has potent anti-inflammatory effects. Skin lesions may respond to the treatment as well. Blood tests must be performed periodically.
Leflunomide (brand name Arava) is a rheumatoid arthritis drug that has been prescribed off-label for the treatment of psoriatic arthritis. Leflunomide, which comes in a pill, is beneficial to some people with psoriatic arthritis, according to recent medical studies.