My mother has psoriatic arthritis. Are biologics safe for her?

Question

Hello doctor,

My mother is 54 and has long-standing psoriasis. Recently, she started experiencing swelling and morning stiffness in her fingers, knees, and ankles. The doctor suspects psoriatic arthritis and suggested starting a DMARD.

However, she already has borderline hypertension and is overweight, so she is anxious about medication side effects. How important is early treatment in preventing joint damage, and how safe are biologics for someone her age?

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

Thank you for sharing your query at iCliniq. I can understand how worrying this must be for both you and your mother.

Your mother is developing signs of psoriatic arthritis (PsA), and thinking about long-term medications understandably raises anxiety.

Regarding your question on how early treatment prevents joint damage, psoriatic arthritis is progressive, meaning the inflammation can gradually damage joints if left untreated.

Delaying treatment increases the risk of irreversible joint changes, and once damage occurs, it cannot be reversed. Starting treatment early is one of the best ways for joint preservation.

As you mentioned, she has hypertension and is overweight; biologics are generally very safe for someone who is 54 years old with borderline blood pressure and some extra weight.

However, they usually do not increase blood pressure, and medicines like TNF (tumor necrosis factor) inhibitors even help slightly by reducing overall inflammation in the body.

Biologics can slightly increase the chance of getting common infections such as colds or chest infections, but serious illnesses are rare, and regular monitoring is important.

One major advantage is that biologics do not harm the liver or kidneys, unlike Methotrexate. Most DMARDs (disease-modifying antirheumatic drugs) like Methotrexate are generally safe for people with hypertension and obesity.

Still, some need a bit of monitoring, but they need frequent blood tests, which can affect the liver, and Leflunomide can worsen blood pressure.

In overweight patients, these medicines may also not work as well.

Biologics can actually be safer and better tolerated than DMARDs for your mother, providing faster results, better control of swelling, stiffness, and joint pain, as well as preventing long-term joint damage.

I hope it helped with your query. I wish your mother good health.

Thank you, and happy healing.