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How to effectively manage psoriatic arthritis flare-ups?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I have been a 38-year-old woman with psoriatic arthritis (PsA) and psoriasis since I was 18. Despite being on methotrexate for two years, my CRP levels remain high, and I still have frequent flare-ups, especially under stress. I have noticed pitted nails and thickened cuticles, which worry me about disease progression. My doctor suggested a TNF inhibitor, but I am concerned about infection risks and the cost. Are there other treatment options or lifestyle changes that can help manage my symptoms and reduce flare-ups?

Kindly help.

Answered by Dr. Raveendran S R

Education:

MBBS

Professional Bio:

Dr. Raveendran S R is a dedicated diabetes specialist and sexual medicine expert committed to providing evidence-based, confidential, and patient-centered care. With strong clinical and academic experience, he specializes in managing diabetes, erectile dysfunction, male infertility, performance concerns, and other men’s health conditions through structured and scientifically guided treatment approaches. Dr. Raveendran focuses on accurate diagnosis, personalized treatment plans, and long-term health improvement while ensuring patient comfort and privacy. Known for his compassionate and professional approach, he believes in clear communication and helping patients make informed decisions to improve their overall health, confidence, and quality of life.

This doctor is not available for online consultations on the platform anymore.

Hello,

Welcome to icliniq.com.

I can understand your concern.

Elevated CRP levels indicate ongoing inflammation, and TNF inhibitors like Adalimumab (Humira) or Etanercept (Enbrel) can help reduce symptoms and prevent joint damage. Although concerns about infections and cost are valid, these treatments are generally well-tolerated, with insurance or patient assistance programs available for affordability.

Other options include interleukin inhibitors (e.g., Secukinumab (Cosentyx) or Guselkumab (Tremfya)) for those not responding to TNF inhibitors. Lifestyle changes, such as low-impact exercise, an anti-inflammatory diet, and stress management, can support treatment. Ensure basic blood tests, including vitamin levels, are normal, and consider biotin supplements after consulting your doctor.

Feel free to follow up with any additional questions or concerns.

I hope that you got an answer.

Please let me know if you need any further help.

Thank you.

Medically reviewed by iCliniq medical review team
Published At December 8, 2024
Reviewed At December 8, 2024

Education:

MBBS

Professional Bio:

Dr. Raveendran S R is a dedicated diabetes specialist and sexual medicine expert committed to providing evidence-based, confidential, and patient-centered care. With strong clinical and academic experience, he specializes in managing diabetes, erectile dysfunction, male infertility, performance concerns, and other men’s health conditions through structured and scientifically guided treatment approaches. Dr. Raveendran focuses on accurate diagnosis, personalized treatment plans, and long-term health improvement while ensuring patient comfort and privacy. Known for his compassionate and professional approach, he believes in clear communication and helping patients make informed decisions to improve their overall health, confidence, and quality of life.

This doctor is not available for online consultations on the platform anymore.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Education:

MBBS

Professional Bio:

Dr. Raveendran S R is a dedicated diabetes specialist and sexual medicine expert committed to providing evidence-based, confidential, and patient-centered care. With strong clinical and academic experience, he specializes in managing diabetes, erectile dysfunction, male infertility, performance concerns, and other men’s health conditions through structured and scientifically guided treatment approaches. Dr. Raveendran focuses on accurate diagnosis, personalized treatment plans, and long-term health improvement while ensuring patient comfort and privacy. Known for his compassionate and professional approach, he believes in clear communication and helping patients make informed decisions to improve their overall health, confidence, and quality of life.

This doctor is not available for online consultations on the platform anymore.

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