How to effectively manage psoriatic arthritis flare-ups?

Question

Hello doctor,

I have been a 38-year-old woman with psoriatic arthritis (PsA) and psoriasis since I was 18. Despite being on methotrexate for two years, my CRP levels remain high, and I still have frequent flare-ups, especially under stress. I have noticed pitted nails and thickened cuticles, which worry me about disease progression. My doctor suggested a TNF inhibitor, but I am concerned about infection risks and the cost. Are there other treatment options or lifestyle changes that can help manage my symptoms and reduce flare-ups?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

Elevated CRP levels indicate ongoing inflammation, and TNF inhibitors like Adalimumab (Humira) or Etanercept (Enbrel) can help reduce symptoms and prevent joint damage. Although concerns about infections and cost are valid, these treatments are generally well-tolerated, with insurance or patient assistance programs available for affordability.

Other options include interleukin inhibitors (e.g., Secukinumab (Cosentyx) or Guselkumab (Tremfya)) for those not responding to TNF inhibitors. Lifestyle changes, such as low-impact exercise, an anti-inflammatory diet, and stress management, can support treatment. Ensure basic blood tests, including vitamin levels, are normal, and consider biotin supplements after consulting your doctor.

Feel free to follow up with any additional questions or concerns.

I hope that you got an answer.

Please let me know if you need any further help.

Thank you.