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Time to Change Psoriatic Arthritis Meds?

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There may be several reasons why your doctor may recommend changing your medication regimen, including the following:

1. You haven’t reached your treatment goals.

One way to measure whether your psoriatic arthritis medication is doing what it should is a strategy called treat-to-target (T2T), according to the Arthritis Foundation.

 In T2T, the doctor sets a predetermined treatment goal, which is usually remission or very low disease activity, and then evaluates the patient periodically (usually every three to six months) to see if they’ve reached the goal. If they haven’t, the physician may increase the medication dose, try a different drug of the same type, or switch to a different drug class altogether.

In treating psoriatic arthritis, it’s important to note that two drugs may not be better than one. Results of a study published in The Lancet: Rheumatology, found that on average, using methotrexate for psoriatic arthritis in addition to ustekinumab (Stelara) or a tumor necrosis factor inhibitor (TNFi) didn’t improve the ability of patients to reach their composite treatment targets.

It’s also worth noting that T2T can be tricky when it comes to psoriatic arthritis, because PsA affects the body in a number of different ways and improvement in one area might not correlate to improvement in another, notes the Arthritis Foundation.

2. You’re experiencing side effects.

Some psoriatic arthritis medications may cause side effects that are bothersome enough to require discontinuing the drug. Side effects may include gastrointestinal irritability, nausea, headaches, and rashes, Rubenstein says. People who take a medication that suppresses the immune system may develop an infection, making it necessary to stop the drug.

Research shows that side effects often affect drug retention rates, causing PsA patients to stop taking their medications.

However, medications should never be stopped without first consulting your doctor, who can determine the cause of any side effects and adjust your treatment plan accordingly.

3. You’re not taking the drug properly.

It can be difficult to follow a medication schedule, says Ellen Amanda Snyder, MD, assistant professor of medicine in the division of rheumatology, allergy, and immunology at the UNC School of Medicine in Chapel Hill, North Carolina. Remembering what you need to take and when you need to take it while also managing work, family, friends, and other commitments isn’t easy, though it does make a real difference, she says. “I find that patients do best when they are able to really focus on taking their medications as prescribed,” says Dr. Snyder.

If that’s something you struggle with, talk with your doctor. They may be able to suggest ways to help you adhere to your medication schedule or switch you to a treatment that’s easier for you to manage.

RELATED: 6 Reasons Why People Quit Their Psoriatic Arthritis Meds — And Why You Shouldn’t

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