Yet according to research published in November 2017 in the Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report that looked at medication adherence among people with chronic disease, medication is not taken as prescribed nearly 50 percent of the time, particularly when it comes to timing, dosage, frequency, and duration. It’s understandable: People who have psoriatic arthritis may experience side effects or face steep medication costs. So it can be tempting to stop taking medication. But before you skip your next dose, talk to your doctor about what’s bothering you. “It’s always better to try to address the underlying issue so you can continue taking your medication as prescribed or find better alternatives,” says Angelica Gierut, MD, a rheumatologist at Northwestern Medicine in Warrenville, Illinois. Here are six reasons you may be tempted to stop taking your medications, along with why you shouldn’t.
1. Your Disease Seems to Be in Remission
Your psoriatic arthritis treatment is working, so you feel little or no joint pain and have minimal swelling. So, you might think, why continue taking your medication? Well, if you stop, you risk your symptoms returning. A small study published in April 2015 in the journal Annals of the Rheumatic Diseases found that 77 percent of people who stopped their disease-modifying antirheumatic drugs (DMARDs) or biologics reported that their disease returned within three to six months. People with longer duration of psoriatic arthritis or more severe disease have the highest risk of recurrence. The Arthritis Foundation recommends you continue to take your medication even if you have low disease activity. But you can talk to your doctor about potentially lowering your dose or stopping one medication if you currently take several medications.
2. You’re Dissatisfied With Treatment
In a survey of 5604 people with psoriasis or psoriatic arthritis published in JAMA Dermatology, nearly half of the respondents with psoriatic arthritis reported they were unhappy with their treatment. If you’re not satisfied with your medications for any reason, from side effects to cost, you’ll likely consider discontinuing them. But there are many psoriatic arthritis medications to choose from, and more are coming. If you’re unhappy with the medication you’re currently taking, Dr. Gierut suggests working with your doctor to find a drug that works for you.
3. You Forgot to Take a Dose
When life gets busy, it can be easy to occasionally forget to take your medication. Missing a dose of medication likely won’t cause a major arthritis flare, according to Gierut. But it’s important to get back on track as soon as possible. Talk to your doctor about what to do if you miss a dose. And if you need help remembering to take your medication on time, try using pill organizers or setting reminders on your smartphone or daily calendar.
4. You’re Dealing With Uncomfortable Side Effects
According to results from the NORdic PAtient survey of Psoriasis and Psoriatic arthritis (NORPAPP) published in February 2019 in the Journal of the European Academy of Dermatology and Venereology, the majority of patients who reported they were “very or quite” dissatisfied with their treatment cited side effects as the reason. If you’re experiencing medication side effects, such as stomach upset or headache, discuss them with your doctor. They can help you find ways to manage side effects, or may be able to lower your dose until you can build up a tolerance or prescribe another medication you can try instead. If you experience serious side effects — such as shortness of breath, major rash, or high fever — call your doctor immediately.
5. Your Medication Is Too Expensive
Biologics can cost anywhere from $10,000 to $30,000 per year, and potentially more than $500,000 for the most expensive options, according to an article published in November 2018 in the journal Drugs. Even with good insurance, the out-of-pocket costs for biologics can still be high. Again, talk with your doctor: “Rheumatologists can suggest alternatives that may be less costly for patients,” Gierut says. Or your doctor may be able to help you find an assistance program to cover some of the costs. Both drug manufacturers and private foundations have these available, according to the National Psoriasis Foundation.
6. You Prefer Natural Remedies
While natural remedies such as turmeric won’t cure psoriatic arthritis, some people find them effective at easing symptoms when used alongside traditional treatment, according to the National Psoriasis Foundation. “I’m perfectly fine with my patients trying other modalities to treat their autoimmune diseases,” Gierut says. However, she notes, there are no robust or large-scale studies that show whether they truly work. Also, some so-called natural remedies may interfere with or cause interactions with your prescription medications. Before adding any of these to your psoriatic arthritis treatment plan, carefully review your options with your rheumatologist.
