Table 4.

Treatment options in PsA

Type of Treatment	Name	Comments
Non-pharmacologic therapies[36]	Physical exercise Diet adjustment Occupational therapy Cessation of smoking	Help improvement treatment outcome; not enough on their own.
NSAIDs[37]	Naproxen Ibuprofen	First line in mild-to-moderate disease. Relieves symptoms but does not stop progression of disease.
DMARDs[37]	Methotrexate Leflunomide Sulfasalazine	Older drugs, no longer preferred as first-line. Can decrease or reverse disease progression.
Biologicals[35] (preferred over DMARDs now):
TNF-alpha inhibitors	Infliximab Adalimumab Etanercept	First-line, more effective.
IL-17 inhibitors	Seckinumab Ixekizumab	Choice after TNF alpha inhibitors
IL 12/23 inhibitor	Ustekinumab
IL 23 inhibitor	Guselkumab
T-cell co stimulator	Abatacept
JAK inhibitor	Tofacitinib	Newly introduced
PDE4 inhibitor	Apremilast	Newly introduced, may be used first-line.

PsA=psoriatic arthritis, NSAIDs=non-steroidal anti-inflammatory drugs, DMARDs=conventional Disease modifying anti-rheumatic drugs, TNF= Tumour necrosis factor, JAK= Janus kinase, PDE4= Phosphodiesterase 4, IL= Interleukin