How does high cholesterol affect psoriatic arthritis treatment?

Question

Hello doctor,

I am a 62-year-old man with psoriatic arthritis, mainly affecting my lower back, knees, and fingers. I have been using Adalimumab for five years, which has helped, but my latest X-rays show worsening joint damage in my fingers. My doctor is concerned the disease is progressing. I also have high cholesterol and take Atorvastatin. My recent blood tests showed high inflammation markers (CRP and ESR). My rheumatologist suggested adding a DMARD to help protect my joints, but I am concerned about taking more medications. Are there other options to manage the disease progression and protect my joints?

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

It sounds like you have been managing psoriatic arthritis (PsA) with biologic therapy, but recent X-rays and elevated inflammation markers C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) indicate that your disease may be progressing. This is understandably concerning, especially after years of treatment with the biological Adalimumab (Humira), which has helped reduce pain and inflammation.

To help slow joint damage and improve symptom control, your doctor might suggest adding a disease-modifying anti-rheumatic drug (DMARD), like Methotrexate (Trexall), alongside Adalimumab. If Adalimumab is less effective now, switching to another biologic, such as Secukinumab (Cosentyx) or Etanercept (Enbrel), might help. Another option could be a Janus kinase (JAK) inhibitor, like Tofacitinib (Xeljanz). Given your high cholesterol, it is important to work closely with your doctor to monitor any side effects.

I hope this helps.

Let me know if you have any other concerns.

Thank you.