The good news for people with psoriatic arthritis is that there are several treatment options available. But finding the one that’s right for you, and knowing when it may be time to try a different treatment, isn’t easy.

“Choosing the best treatment for psoriatic arthritis can be challenging,” agrees Rochella Ostrowski, MD, associate professor at Loyola University Chicago Stritch School of Medicine and rheumatologist for Loyola University Health System in Maywood, Illinois. “There are no strict rules.”

There are also several reasons for switching treatment, points out Reshma Marri-Gottam, MD, rheumatologist with Newland Medical Associates in Bingham Farms, Michigan. One reason might be that the patient isn't tolerating a certain medication or is having an adverse reaction.

Nonsteroidal anti-inflammatory drugs (NSAIDs), for example, can ease psoriatic arthritis pain and inflammation, but possible side effects include stomach and heart problems. Similarly, disease-modifying anti-rheumatic drugs (DMARDs) like methotrexate prevent disease progression and joint damage but can also cause hair loss, mouth ulcers, and liver damage.

“Obviously, compliance is a very important predictor of optimal outcomes,” says John Carter, MD, chief of the division of rheumatology at the University of South Florida in Tampa. “But it’s also very important for the patient to be wary of potential side effects when they start a new medication.”

Is the Patient Responding?

Another reason for changing a patient’s treatment “is if they’re just not responding to the medication,” says Dr. Marri-Gotham.

“Patients should be proactive about their health and talk to their doctors immediately if they believe their current treatment isn’t working,” says Anjali Casey, MD, rheumatologist with NorthShore Medical Group in Glenview, Illinois. “We can counsel on how they are taking the medication, and can adjust doses of their current treatment so that it can be more effective.”

Treatment Takes Time

Still, doctors advise giving any treatment the time it needs to take effect. Dr Casey adds, “We can look into treatments that will have a more immediate effect while the long-acting medication takes time to work.”

Your doctor may want to do X-rays and blood tests to monitor the disease’s severity and see how you're responding to a particular treatment. “After a few months, if a patient is tolerating the medication but is still having symptoms, it's time to look at changing the therapy,” Casey says.

Your rheumatologist may also change your medication if a newer option can treat the condition more effectively.

Changing psoriatic arthritis treatment is very common. According to a study published in August 2014 in the journal Arthritis Research and Therapy, as many as 69 percent of patients had at least one treatment change within a 12-month period.

Work With Your Doctor

The key to effective treatment is for patient and doctor to work together in determining when a treatment is working and when it may be time to try something else. “The best patient-physician relationship is always a two-way street,” says Dr. Carter.

Julie Cerrone, 30, agrees. She has undergone many different treatments for her psoriatic arthritis over the years, and knows the importance of playing an active role in the treatment plan. Cerrone’s advice to others is to “learn as much as you can about the disease, form a partnership with your doctors and healthcare team, and realize that you are the expert on your body.”