Psoriatic Arthritis: How do you manage PA and flares?

Posted by lemdjm @lemdjm, Feb 27, 2017

I am a 74 year old female who has had psoriasis for over 40 years. The psoriasis was present on my scalp and ears in flares from time to time. I never experienced joint swelling and joint pain until recently. About one month ago I experienced an abrupt onset of severe joint swelling in my hands wrists, feet, and neck with severe pain. At first I suspected that it might have been related to my oncology medication, Arimedex that I began taking approximately 4 months before my sudden joint problems began. Testing ruled out Rheumatoid Arthritis and Lupus. My oncologist did not think that the joint issues could be related to the Arimedex, however, he recommended that I suspend taking the cancer medication for 4 weeks while I was given oral Prednisone for 23 days (referred to as Pulse and taper). I am on day 22 of the Prednisone and the joint swelling and pain is no longer present. My oncologist wants me to resume the Arimedex, however, I am afraid that the severe joint pain will return. I am hopeful that additional diagnostic testing will determine the underlying cause of my joint swelling. If anyone reading this has had similar problems or any information related to my situation I would be interested in your comments. Thank you.
lemdjm

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annieg87 | @annieg87 | May 25 5:56pm

In reply to @seniormed "Has anyone had success with Otezla for PsA or found it helpful with Enthesitis symptoms?" + (show)

Hopefully, I am an exception regarding Otezla. I was doing well on Cimzia, but during the pandemic my rheumatologist switched me to Otezla, believing it to be less immunosuppressive. I was on it for 7 months. My psoriasis came back; I had a painful flare of enthesitis in my left thigh and had to use a cane, and I developed tachycardia (rapid heartbeat) with the end result being a trip to the ER and a diagnosis of Afib (atrial fibrillation).
I didn’t experience any of the usual side effects listed for Otezla, and Afib wasn’t even on the list. Fortunately, in the National Psoriasis Foundation’s support community there was a member who had experienced the same thing. She had found the product monograph for Otezla (apremilast) and under “warnings and precautions” tachyarrhythmia, including atrial fibrillation was listed. On eHEALTHME, a phase IV clinical study of FDA data reported the same findings.
Apparently, this side effect isn’t common, and as with that other member, my doctors weren’t aware of it. I was prescribed a medication for the Afib, to be taken long-term.
Besides it causing constant palpitations, I was reluctant to take it since I suspected the Otezla was the cause, so I discontinued both medications and have had no further issues. My rheumatologist let me go back to the Cimzia.

zenalucy | @zenalucy | Jul 8 8:59pm

In reply to @peach414144 "terrible pain and cannot use aspirin (advil) due to kidney disease. tylenol does nothing, zero, zero,..." + (show)

hi, yes I think Marijuana and in most states medical marijuana is legal, and probably would help you.

I have had Psoriatic Arthritis for 30 years and it had been controlled via various TNF blockers ubntil 6. months ago. Now , none of the ones I have tried have worked, at all. I can take prednisone if my pain is really bad but do NOT want to be on it daily. So many side effects, severe bone loss, osteophoritis, etc..... , irritability.

There is a new medication but it would cost me 2000.00/ month and I really can NOT afford it.
XELJANZ. XR. Has anyone or is anyone on it?

zenalucy | @zenalucy | Jul 13 5:53pm

In reply to @fransav "Hi! I've had PsA for many years, I am now 70. Been on Methotrexate, Azulfadine, &..." + (show)

I also have PSA. I'm sorry but what I will write may not be useful for you

I was on various Biologics for 30 years and did very well. In Nov the one I was one stopped working and I have tried 4 others without success. I guess the TNF blockers are not working anymore for me. I met with my Rheumatologist recently and now she's saying that my symptoms, which is that in various places in my lower body , it feels like I'm on fire, sort of.
She said that I may have fibromyalgia because I have no swelling. This is weird to me, how does PA morph into fibromyalgia? I had some blood work done, so I'll see. I am planning to see a rheumatologist at Hopkins who only sees people with PSA. I think that if what you're dong is not working you should go see someone else for a consult.

seniormed | @seniormed | Jul 13 7:33pm

In reply to @zenalucy "I also have PSA. I'm sorry but what I will write may not be useful for..." + (show)

You are fortunate to have a good second opinion and management.
I was thinking of Otezla as an alternative therapy after Humira.
Now I will consider other options
and learn more about the disease.

zenalucy | @zenalucy | Jul 14 12:53pm

Everyone responds differentlyt to each Biologic. I never had a side effect from any of them. They just Stopped working for me after 30 years.

zenalucy | @zenalucy | Jul 14 2:29pm

In reply to @zenalucy "Everyone responds differentlyt to each Biologic. I never had a side effect from any of them...." + (show)

Yes, you definitely should know more about PA and the biologics and how they work.

mpeitch | @mpeitch | Sep 22 9:14am

My 39 yr old daughter has PA with severe inflammation and prain. She too was prescribed Prednisone which resulted in a 60 pound weight gain. Having exhausted all the programs our government offers (we are Canadian), she is on her 3rd biologic treatments which are offered by pharmaceutical companies before the med is released to the public. So far, nothing has worked. It's been eight years!