What is the best treatment for worsening psoriatic arthritis?

Question

Hello doctor,

My elderly father, who is 72, has been diagnosed with psoriatic arthritis, and his symptoms are getting worse. His joints are swollen, stiff, and painful, and he is having trouble walking and using his hands. The doctor has prescribed DMARDs or possibly biologics, but I am concerned about side effects due to his age. Are these treatments safe for someone older, or should we consider other options like physical therapy or pain management? I want to make sure he is as comfortable as possible without putting him at risk for other health issues. What is the best treatment plan?

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I went through your query.

You mentioned that your father is suffering from psoriatic arthritis (PsA). So, I suggest the following treatment options.

1. Medications: Consult with a rheumatologist regularly and continue all the medicines prescribed for the disease. These include painkillers to reduce pain and some special medicines that decrease the disease activity.

DMARDs (Disease-modifying antirheumatic drugs): These medications can help slow disease progression and reduce inflammation. While they can have side effects, many older adults tolerate them well. Close monitoring by his healthcare provider can help manage potential risks.

Biologics: These are newer medications that target specific pathways in the inflammatory process. They can be effective in controlling symptoms and preventing joint damage. Safety profiles have improved, and many older adults are prescribed biologics, but there may be an increased risk of infections, so monitoring is essential.

Discuss with his doctor the potential benefits versus risks of starting these medications. Older adults can sometimes have different responses to treatments, and the healthcare provider may adjust doses or choose specific medications based on their overall health and any other conditions they may have.

2. Physical Therapy: It includes exercises that improve flexibility and strength while minimizing pain.

3. Lifestyle Changes and Healthy Diet: A diet rich in fruits, vegetables, whole grains, and omega-3 fatty acids may help reduce inflammation.

4. Stress Management: Stress can exacerbate symptoms, so techniques like mindfulness, meditation, or deep-breathing exercises can be beneficial.

5. Adequate Sleep: Encourage the patient to prioritize sleep and establish a routine that helps improve sleep quality.

6. Avoiding Triggers: Help the patient identify and avoid any specific triggers for psoriasis, such as stress, certain foods, or skin injuries.

7. Emotional Support: Let the patient know you are there to listen. Sometimes, just having someone to talk to can make a big difference. Support the patient in sticking to the treatment plan and lifestyle changes.

8. Involvement: Offer to join in activities that promote well-being, like exercising together or cooking healthy meals.

9. Be Patient: Understand that there may be days when the patient feels overwhelmed or frustrated. Just being present can be incredibly comforting.

10. Educate Yourself: Learning about PsA and psoriasis can help you understand what he is going through, making it easier to empathize and provide support.

Being there for your father in a supportive and understanding way can make a significant difference in his journey with psoriatic arthritis. Your care and compassion can be invaluable as he navigates this challenging time.

Take care.

I hope this helps.

Thank you.