Variable symptoms of psoriatic arthritis
There are typically 6 variants of psoriatic arthritis:
(1) Swelling of both the joint and tendon so that the involved toe or finger resembles a sausage
(2) Involvement of the joints next to the finger nails - often those nails will contain tiny pits
(3) Similar appearance to rheumatoid arthritis (RA) - eg. symmetrical involvement of the hands, feet, knees or ankles
(4) Involvement of the spine - typically associated with the HLA-B27 gene
(5) A very destructive, deforming arthritis - rare
(6) Associated with the HIV infection - while uncommon, this typically occurs with a very severe form of psoriasis
Treatment of psoriatic arthritis
Medications used to treat psoriatic arthritis are similar to those used to treat rheumatoid arthritis. They include the NSAIDs (nonsteroidal anti-inflammatory drugs), as well as DMARDs (disease modifying anti-rheumatic drugs) including:
While all three TNF blockers can be used for this condition, to date, only etanercept (Enbrel) and infliximab (Remicade) are FDA approved for treatment of psoriatic arthritis.
As opposed to rheumatoid arthritis, there is no definitive study showing that early treatment with the disease modifying drugs makes a diffence in long term outcome, so the choice of therapy is often based on the patients symptoms.
Related Resources - Psoriatic Arthritis
Answer provided by Scott J. Zashin, M.D., clinical assistant professor at University of Texas Southwestern Medical School, Division of Rheumatology, in Dallas, Texas. Dr. Zashin is also an attending physician at Presbyterian Hospitals of Dallas and Plano. He is a fellow of the American College of Physicians and the American College of Rheumatology and a member of the American Medical Association. Dr. Zashin is author of Arthritis Without Pain - The Miracle Of Anti-TNF Blockers. The book is a must-have for anyone on one of the biologic drugs (Enbrel, Remicade, Humira) or considering the biologic drugs. Read my review of the book.
