I have just been diagnosed with a special kind of arthritis called psoriatic arthritis. It progressed from some mild joint swelling to a full blown, severe case in a matter of days. My doctor is talking about which medication is best to treat this. What do your experts say?

Psoriasis is a disease that most people think of as primarily a skin disease because the condition causes a persistent rash in various areas of the body. Psoriatic arthritis is a type of joint disease that occurs in roughly seven percent of people who have psoriasis.

Psoriatic arthritis affects people of all ages, but most get it between the ages of 30 and 50. Usually a patient has psoriasis (the skin rash) for many years before the arthritis develops, and the arthritis comes on slowly. Patients with psoriatic arthritis must manage both the outbreaks of itchy, scaly skin and the pain and stiffness of arthritis.

One of the most commonly used medications for the treatment of psoriatic arthritis (PsA) is a disease-modifying antirheumatic drug (DMARD) called methotrexate. DMARDs like methotrexate not only control symptoms, they also slow the progression of disease. That’s what makes them “disease-modifying”.

Methotrexate may not be as effective with psoriatic arthritis as it is with rheumatoid arthritis without the psoriasis. Some patients don’t respond at all while others have an adverse reaction to the medication. And in some cases, it may be necessary to combine methotrexate with another drug (e.g., infliximab) to get the desired results (decreased joint pain, swelling, and stiffness).

Infliximab is a type of disease-modifying medication in a class called anti-tumor necrosis factor (TNF) agents. The anti-TNF agents are a special type of antibody referred to as human monoclonal antibodies. They specifically target (and inhibit) tumor necrosis factor.

Tumor necrosis factor (TNF) promotes the inflammatory response, which in turn causes many of the clinical problems associated with autoimmune disorders such as rheumatoid arthritis. Golimumab is another new TNF-inhibitor that has been approved by the FDA for use with patients who have active moderate-to-severe psoriatic arthritis (PsA).

Your doctor will help you figure out which treatment approach might work best for you. Sometimes it takes a while (through trial and error) to find the right medication or best combination of therapies to get the optimal results.

There are also alternative kinds of therapy as well that help manage the disease such as acupuncture, Reiki, Therapeutic Touch, BodyTalk, and even hypnosis. Some patients seem to get a better response by combining traditional treatment (medications) with these complementary approaches.