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Stopping Psoriatic Arthritis Drugs May Cause Flare-Ups

Why it is important to stick with treatment, even during remission.

Medically reviewed in November 2021

People with psoriatic arthritis may want to stop taking their disease-modifying drugs once the disease is in remission, but research suggests that’s a bad idea. Going off these types of medications, such as traditional disease-modifying antirheumatic drugs (DMARDs) and biologics, could bring all the pain and stiffness back.

As many as 30 percent of people with psoriasis also develop psoriatic arthritis, an autoimmune disease where the body’s immune system attacks the joints, causing pain, swelling, stiffness and potential damage. Disease-modifying medications can provide relief from these symptoms because they are designed to slow or even stop disease activity in the body. When there is little to no disease activity, this is called remission—but it doesn’t necessarily last.

Researchers followed 26 psoriatic arthritis patients whose disease was in remission. All of the participants were taken off of their disease-modifying antirheumatic drugs (DMARDs) or TNF inhibitor (a type of biologic drug) and monitored over the course of six months. Twenty out of the 26 patients (close to 80 percent) experienced their psoriatic arthritis symptoms return within about two to three months of stopping their medication. The study was published in the journal Annals of the Rheumatic Diseases.

How psoriatic arthritis medication works
DMARDs, such as methotrexate, can help block your immune system from attacking healthy cells in your skin and joints. TNF inhibitors, such as Enbreland Humira, work to stop the proteins responsible for causing inflammation. What this small study suggests is that even though these drugs can help people achieve remission from psoriatic arthritis, they are still necessary for long-term control of the disease.

Understanding psoriatic arthritis
Some people with psoriatic arthritis have only mild symptoms with occasional flare-ups, while others have severe, continuous pain. Regardless of the severity of symptoms, treatment, especially early in the disease, can help prevent joint damage. Not treating psoriatic arthritis can cause joints to become permanently deformed and lead to long-term discomfort and disability. Unfortunately a large number of people with psoriatic arthritis forgo treatment because they experience unpleasant side effects.

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