@rdf56, According to the Arthritis Foundation, it is possible to have PsA without psoriasis - https://www.arthritis.org/diseases/more-about/expert-q-a-psa-without-psoriasis. I'm sorry to hear that you are struggling to find a better treatment. Hoping other members with some experience will be able to offer some suggestions. You are not alone. I did a search of Connect for members posting about rheumatoid arthritis with psoriatic arthritis and found a few discussions along with quite a few comments. Here is the search link that lists the discussions and comments if you want to scan through them while you wait for others to respond - https://connect.mayoclinic.org/search/discussions/.