Psoriatic arthritis

Psoriatic arthritis is a spondyloarthritis and a form of joint inflammation that occurs in some people who have psoriasis of the skin or nails.

  • Joint inflammation can develop in people who have psoriasis.
  • Joints commonly involved include the hips, knees, and those closest to the tips of the fingers and toes.
  • The diagnosis is based on symptoms.
  • Nonsteroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs (such as methotrexate), cyclosporine, and tumor necrosis factor inhibitors can help.

Psoriatic arthritis is a type of spondyloarthritis.

Psoriatic arthritis resembles rheumatoid arthritis but does not produce the antibodies characteristic of rheumatoid arthritis. Psoriatic arthritis occurs in about 30% of people with psoriasis (a skin condition causing flare-ups of red, scaly rashes and thickened, pitted nails). People with a certain gene (HLA-B27) and those who have affected family members are at increased risk of psoriatic arthritis of the spine. The cause of psoriatic arthritis is unknown.


  • Disease-modifying antirheumatic drugs
  • Tumor necrosis factor inhibitors
  • Ustekinumab, secukinumab, and apremilast

Treatment of psoriatic arthritis is aimed at controlling the rash and relieving the joint inflammation. Several drugs that are effective in treating rheumatoid arthritis are also used to treat psoriatic arthritis, particularly nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs—especially methotrexate), cyclosporine, and tumor necrosis factor (TNF) inhibitors (such as adalimumab, etanercept, infliximab, certolizumab pegol, and golimumab). TNF inhibitors are particularly effective for psoriatic arthritis.

Ustekinumab, given by injection, and apremilast, taken by mouth, are other biologic agents that can be used to treat moderate to severe psoriatic arthritis.
Secukinumab, an interleukin-17A receptor antagonist, can also reduce inflammation and joint symptoms.