Psoriatic Arthritis Medications List

psoriatic arthritis treatment

Psoriatic Arthritis is an autoimmune disease. It affects people who have psoriasis, a chronic skin and nail disease. In psoriatic arthritis, the joints become swollen and painful.

Here is a list of medications used to treat psoriatic arthritis based on their mechanism of action, date of approval, and important contraindications:







DMARDs, ImmunosuppressantsMethotrexate





TNF InhibitorsEtanercept





Interleukin inhibitorsUstekinumab




Janus Kinase InhibitorsTofacitinib

List of NSAIDs used to treat Psoriatic Arthritis:

NSAIDs (non-steroidal anti-inflammatory drugs) are used to relieve pain and inflammation in the joints.

NSAIDs are commonly used as reliever medicines rather than controlling the disease.

Indomethacin for psoriatic arthritis:

Generic Name: Indomethacin

Trade Name: Indocin

Company Name: Mediceena pharma (PVT) LTD.

Date of approval:


Inhibits prostaglandin formation in bodily tissues by inhibiting at least two cyclo-oxygenases (COX) isoenzymes, COX-1 and COX-2.

It may reduce pro-inflammatory cytokine activity, block neutrophil aggregation, change lymphocyte activity, and inhibit chemotaxis; these outcomes may help with anti-inflammatory activity.


Indocin is used to alleviate the pain, stiffness, and discomfort produced by psoriatic arthritis.

Major contraindications:


  • Thrombocytopenia
  • Untreated infection
  • Renal impairment
  • Active bleeding (Intracranial hemorrhage and GI bleeding)
  • Necrotizing enterocolitis


  • CABG surgery-related preoperative pain
  • History of hypersensitivity
  • History of asthma, urticaria, or allergic response to aspirin.
  • History of recent rectal bleeding (Suppositories) or proctitis.


  • Ulcerative colitis
  • Upper GI disease
  • Late pregnancy
  • Stomatitis
  • Bleeding disorder
  • peptic/gastric/duodenal ulcer
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Ibuprofen for Psoriatic arthritis

Generic Name: Ibuprofen

Trade Name: Motrin IB, Advil, Neoprofen

Company Name: Pfizer Inc.

Date of approval:


Inhibits prostaglandin formation in bodily tissues by inhibiting at least two cyclo-oxygenases (COX) isoenzymes, COX-1 and COX-2.

It may block chemotaxis, modify lymphocyte activity, decrease proinflammatory cytokine activity, and inhibit neutrophil aggregation; these effects may contribute to anti-inflammatory efficacy.


It is used to alleviate pain associated with conditions like psoriatic arthritis, rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis when taken orally.

Major contraindications:

  • Perioperative discomfort in the setting of coronary artery bypass graft (CABG) surgery.
  • Hypersensitivity to the medication, other NSAIDs, aspirin, or excipients
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Naproxen for Psoriatic Arthritis

Generic Name: Naproxen

Trade Name: Naprosyn, Naprelan, Aleve, Anaprox

Company Name: Bayer HealthCare

Date of approval: February 17, 2006


Naproxen inhibits both cyclooxygenase (COX) isoenzymes, COX-1 and COX-2, competitively, resulting in analgesic and anti-inflammatory actions.


It is used in the therapy of psoriatic arthritis, rheumatoid arthritis, osteoarthritis, or juvenile arthritis.

Major contraindications:


  • Preoperative discomfort in the setting of coronary artery bypass graft (CABG) surgery.
  • Aspirin allergy


  • Late pregnancy
  • Bleeding disorder
  • Hepatic disease
  • Delayed esophageal transit
  • Peptic ulcer
  • Renal transplant
  • Stomatitis
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Diclofenac for Psoriatic Arthritis

Generic Name: Diclofenac

Trade Name: Zorvolex, Cambia

Company Name: GlaxoSmithKline (GSK)

Date of approval: 


Inhibits cyclooxygenase (COX)-1 and COX-2, consequently inhibiting prostaglandin production.

It may also suppress neutrophil aggregation/activation, chemotaxis, proinflammatory cytokine levels, and alter lymphocyte activity.


It is used to treat psoriatic arthritis, rheumatoid arthritis, and osteoarthritis.

Major contraindications:

  • For those who have a history of hypersensitivity to bovine protein, Zipsor capsules are not advised.
  • In the setting of CABG surgery.
  • Hypersensitivity to any of the product’s components, including diclofenac (such as anaphylaxis or severe skin reactions).
  • Prior use of aspirin or other NSAIDs followed by a history of urticaria, asthma, or other allergic-like symptoms.

Oral Small Molecules: Immunosuppressants, DMARDs for Psoriatic Arthritis:

DMARDs (disease-modifying anti-rheumatic drugs are the usual first-line drugs added to the treatment regimen of patients with active psoriatic arthritis.

DMARDs can be combined with NSAIDs and biological agents like TNF inhibitors in patients who do not adequately respond to monotherapy alone.

Methotrexate for Psoriatic Arthritis:

Generic Name: Methotrexate

Trade Name: Trexall, Otrexup

Company Name:  Pfizer Laboratories LTD.

Date of approval: February 26, 1999


Methotrexate is a disease-modifying antirheumatic drug used to treat psoriatic arthritis. It works by blocking the metabolism of folic acid, leading to the inhibition of DNA synthesis and cell growth.

Methotrexate also reduces the production of cytokines, signaling molecules that play a role in the inflammatory response. This helps to reduce inflammation and improve the symptoms of psoriatic arthritis.


It is used for the therapy of psoriatic arthritis, rheumatoid arthritis, and any other inflammatory joint condition.

Major contraindications:

  • Known hypersensitivity; extreme reactions observed.
  • Pregnant woman with nonmalignant illness.
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Sulfasalazine for Psoriatic Arthritis:

Generic Name: Sulfasalazine

Trade Name: Azulfidine, Azulfidine EN

Company Name: Pfizer Laboratories LTD.

Date of approval: –


Sulfasalazine is a prodrug that is broken down into its active ingredients, sulfapyridine and 5-aminosalicylic acid (5-ASA; mesalamine); the anti-inflammatory characteristics of 5-ASA, which blocks the formation of leukotriene and lipoxygenase, are primarily responsible for the beneficial effects.


Psoriatic arthritis, spondyloarthropathies including IBD-associated arthritis

Major contraindications:

  • Intestinal or urinary tract obstruction
  • Porphyria
  • Hypersensitivity to sulfasalazine and its metabolites

Cyclosporine or Ciclosporin for Psoriatic Arthritis:

Generic Name: Cyclosporine, Ciclosporin

Trade Name: Neoral, Gengraf

Company Name: Novartis Pharmaceuticals Corporation

Date of approval: 1997 [ref]


Cyclosporine acts as a P-glycoprotein inhibitor, a calcineurin inhibitor, and a cytochrome P450 3A4 inhibitor.

Cyclosporin A (CsA) prevents the production of interleukins (IL), notably IL-2, which is necessary for the self-activation and differentiation of T lymphocytes (LT).


It is used for the therapy of psoriatic arthritis and other autoimmune and inflammatory diseases, including rheumatoid arthritis and lupus.

Major contraindications:

  • Breastfeeding
  • Hypersensitivity
  • (Psoriasis use) Concurrent PUVA, UVB radiation, coal tar, methotrexate, and other immunosuppressants.
  • (RA/Psoriasis use): Abnormal renal function, uncontrolled HTN, malignancies.
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Leflunomide for Psoriatic Arthritis:

Generic Name: Leflunomide

Trade Name: Arava

Company Name:  Lupin LTD

Date of approval: September 10, 1998


Leflunomide’s active metabolite, A771726, has the ability to inhibit the human enzyme dihydroorotate dehydrogenase (DHODH) and has antiproliferative properties.


Leflunomide and methotrexate work well together to lessen psoriatic arthritis patients’ skin involvement and joint discomfort.

Major contraindications:

  • Hypersensitivity
  • Pregnancy
  • Serious hepatic impairment
  • Current teriflunomide therapy

Apremilast for Psoriatic Arthritis:

Generic Name: Apremilast

Trade Name: Otezla

Company Name: Amgen Inc

Date of approval: March 21, 2014 [ref]


Apremilast is an orally accessible targeted PDE4 inhibitor that affects a wide range of inflammatory mediators involved in psoriatic arthritis, including decreases in inducible nitric oxide synthase, TNF-α, and interleukin (IL)-23 production and increases in IL-10.


Active psoriatic arthritis is treated with apremilast.

Major contraindications:

Hypersensitivity to apremilast or any of the formulation’s excipients.

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TNF Inhibitors indicated for the treatment of Psoriatic Arthritis:

TNF inhibitors are being increasingly used for the treatment of psoriatic arthritis. They are more potent and safer than conventional DMARDs.

Etanercept for Psoriatic Arthritis:

Generic Name: Etanercept

Trade Name: Enbrel, Erelzi

Company Name: Sandoz, Switzerland

Date of approval: January 2002 [ref]


Etanercept is a biological tumor necrosis factor (TNF) inhibitor. TNF is a cytokine that is involved in inflammation and the immune response and can connect to TNF receptor 1 (TNFR1) or TNF receptor 2 (TNFR2).

Etanercept acts by inhibiting TNF-alpha, a pro-inflammatory cytokine that is increased in psoriasis, psoriatic arthritis, and rheumatoid arthritis.


Etanercept injections are used to treat the signs and symptoms of psoriatic, rheumatoid, and active arthritis, such as joint pain, edema, exhaustion, and the length of morning stiffness.

Major contraindications:

  • Hypersensitivity
  • Sepsis

Infliximab for Psoriatic Arthritis:

Generic Name: Infizimab

Trade Name: Inflectra, Remicade, Renflexis

Company Name: Pfizer Laboratories LTD.

Date of approval: May 2005 [ref]


Infliximab suppresses TNF-α activity via binding to the transmembrane and soluble forms of the protein, as well as inhibiting TNF-α from interacting with its receptor.

TNF-α’s biological actions include the induction of inflammatory cytokines such as interleukin-1 (IL-1) and IL-6, the facilitation of leukocyte migration, the induction of eosinophil and neutrophil activity, and the stimulation of acute-phase reactants and tissue-degrading enzymes.


Infliximab is used to improve physical function, slow the development of structural damage, and lessen the signs and symptoms of active arthritis in psoriatic arthritis patients.

Major contraindications:

  • Hypersensitivity
  • Active severe infection
  • doses above 5 mg/kg for individuals with moderate-to-severe heart failure (NYHA Class III/IV).
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Adalimumab for Psoriatic Arthritis:

Generic Name: Adalimumab

Trade Name: Amjevita, Cyltezo, Humira, Hadlima, Hyrimoz, Adalimumab-atto, Adalimumab-adbm, Adalimumab-bwwd, Adalimumab-adaz

Company Name: AbbVie Inc.

Date of approval: October 2005[ef]


Adalimumab is a Recombinant human anti-TNF-α IgG1 monoclonal antibody; blocks TNF-α’s ability to cause inflammation; it binds to TNF-α selectivity and prevents it from interacting with the p55 and p75 cell surface TNF receptors; lyses surface TNF-expressing cells in vitro; and modifies the biological processes that control leukocyte migration.


Adalimumab is a medication used to treat the pain and swelling caused by some kinds of arthritis (such as psoriatic, juvenile idiopathic, and ankylosing spondylitis).

Major contraindications: None

Golimumab for Psoriatic Arthritis:

Generic Name: Golimumab

Trade Name: Simponi, Simponi Aria

Company Name:  Janssen Biotech, Inc.

Date of approval: April 2009 [ref]


Human anti-TNF-alpha monoclonal antibody binds to both soluble and transmembrane bioactive forms of human TNFα; blocks TNF-alpha binding to its receptors, hence inhibiting TNF biological activity (a cytokine protein).


Golimumab is used to treat the symptoms of a number of active inflammatory illnesses, including psoriatic arthritis, rheumatoid arthritis, ankylosing spondylitis, and ulcerative colitis.

Major contraindications: None

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Certolizumab pegol for Psoriatic Arthritis:

Generic Name: Certolizumab pegol

Trade Name: Cimzia

Company Name:  UCB Group of Companies

Date of approval: September 27, 2013 [ref]


Certolizumab pegol binds to both soluble and membrane-bound TNF-α, reducing the cytokine’s proinflammatory activities.

In contrast to other TNFi, it is unable to fix complement or bind to Fc receptors because it lacks the Fc component.


Psoriatic arthritis is another condition for which Certolizumab is occasionally used.

Major contraindications:

  • Serum sickness
  • Anaphylactoid reaction
  • Hypersensitivity to certolizumab pegol or any of its excipients; responses have included angioedema.

Interleukin Inhibitors for the treatment of Psoriatic Arthritis:

Interleukin inhibitors are among the newly approved medications approved by the FDA for the treatment of psoriatic arthritis.

Different Interleukin inhibitors affect different pathways.

Ustekinumab for Psoriatic Arthritis:

Generic Name: Ustekinumab

Trade Name: Stelara

Company Name: Janssen Pharmaceuticals

Date of approval: September 24, 2013 [ref]


Human IgG1κ monoclonal antibody binds to the p40 protein subunit used by the cytokines IL-12 and IL-23; IL-12 and IL-23 are implicated in inflammatory and immunological responses (for example, natural killer cell activation, CD4+ T-cell differentiation, and activation).


Psoriatic arthritis is treated with this drug.

Major contraindications:

  • Concomitant live vaccines
  • Active serious infection
  • Hypersensitivity
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Guselkumab for Psoriatic Arthritis:

Generic Name: Guselkumab

Trade Name: Tremfya

Company Name:  Janssen Global Services, LLC.

Date of approval: July 2020 [ref]


Guselkumab is a monoclonal antibody (IgG1-lambda) that suppresses IL-23 by specifically binding to its p19 subunit; IL-23 is a natural cytokine linked with inflammatory and immunological responses; guselkumab inhibits IL-23’s pro-inflammatory activities, hence lowering cytokine and chemokine release.


It is used for the treatment of adult patients with active psoriatic patients.

Major contraindications:

History of severe hypersensitivity to guselkumab or any of the excipients.

Ixekizumab for Psoriatic Arthritis:

Generic Name: Lxekizumab

Trade Name: Taltz

Company Name:  Eli Lilly and Company

Date of approval: March 22, 2016


Ixekizumab is a humanized monoclonal IgG4 antibody that targets and neutralizes the proinflammatory effects of interleukin-17A (IL-17A).

IL-17A is a naturally present cytokine that is essential for healthy immunological and inflammatory responses and plays a significant role in the development of plaque psoriasis.


Psoriatic arthritis is another condition for which Abatacept is occasionally used.

Major contraindications:

Hypersensitivity reaction ( e.g., anaphylaxis) to the medicine or excipients.

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Secukinumab for Psoriatic Arthritis:

Generic Name: Secukinumab

Trade Name: Cosentyx

Company Name: Novartis Pharmaceuticals UK Ltd.

Date of approval: January 2016 [ref]


Secukinumab binds to and inhibits IL-17A3, preventing it from interacting with the IL-17 receptor and activating the IL-17 receptor signaling pathway, which is linked to inflammatory processes.


Secukinumab is used to treat psoriatic arthritis alone or in conjunction with methotrexate.

Major contraindications:

Hypersensitivity Reactions

Selective co-stimulation modulators for Psoriatic Arthritis:

Abatacept (Orencia) is the pioneer drug in this category and one of the safest medications for the treatment of psoriatic arthritis.

Abatacept for Psoriatic Arthritis:

Generic Name: Abatacept

Trade Name: Orencia, Orencia ClickJect

Company Name: Bristol-Myers Squibb Company

Date of approval: July 2017 [ref]


Abatacept is a selective costimulation modulator that, has been demonstrated to decrease T-cell activation by binding to CD80 and CD86, thereby preventing interaction with CD28.

This interaction has been found to hinder the delivery of the second co-stimulatory signal essential for effective T-cell activation.


Psoriatic arthritis is another condition for which Abatacept is occasionally used.

Major contraindications: 


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JAK-STAT inhibitors for the treatment of Psoriatic Arthritis:

Tofacitinib is an oral JAK-STAT inhibitor indicated for the treatment of psoriatic arthritis, apart from its use in Rheumatoid arthritis and IBDs.

Tofacitinib for Psoriatic Arthritis:

Generic Name: Tofacitinib

Trade Name: Xeljanz, Xeljanz XR

Company Name:  Pfizer Inc.

Date of approval: 2017 [ref]


Tofacitinib is a partial and reversible JAK inhibitor that prevents the body from reacting to cytokine signals.

Tofacitinib suppresses the phosphorylation and activation of STATs by inhibiting JAKs.

The JAK-STAT signaling pathway is involved in the transcription of cells engaged in hematopoiesis and immune cell activity. Tofacitinib reduces inflammation by blocking the JAK-STAT pathway.


Tofacitinib is used alone or with other medications to treat psoriatic arthritis, rheumatoid arthritis, ulcerative colitis, and pcJIA.

Major contraindications: 


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Written by Dr. Ahmed

I am Dr. Ahmed (MBBS; FCPS Medicine), an Internist and a practicing physician. I am in the medical field for over fifteen years working in one of the busiest hospitals and writing medical posts for over 5 years.

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