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Worried about catching a cold or influenza (the flu)? Depending on your type of treatment for psoriatic arthritis (PsA), you may be more prone to infections. Common immunosuppressant drugs that are used to treat autoimmune diseases may make your immune system less active — and less able to fight bacteria and viruses.
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“I have been sick three times in the last month or so,” one MyPsoriasisTeam member wrote. “My immune system is so whacked 😩, and I still don’t feel good.”
This article will discuss how having psoriatic arthritis and using certain treatment options may affect your risk of common infections, including influenza.
Influenza is a contagious viral infection that can cause mild to severe illness. Symptoms of the flu include:
Sometimes it can be hard to tell the difference between the flu and other types of viral and bacterial infections. Your doctor can diagnose you with the flu, and over-the-counter flu tests are also available.
Most people are able to fight off the flu, but for some, infection poses the risk of complications. According to the Arthritis Foundation, people with rheumatic diseases like psoriatic arthritis are at a higher risk of flu complications. These can include:
“I had a bad week with the flu and then a chest infection,” a MyPsoriasisTeam member shared.
People with autoimmune diseases like psoriatic arthritis are at a higher risk of getting the flu and other infections. One reason: For people with different types of inflammatory arthritis like PsA, changes in the immune system may affect their ability to fight infections.
However, a bigger part of the increased risk comes from medications used to treat PsA. According to the Arthritis Foundation, immunosuppressant drugs for treating psoriatic arthritis are a major factor in the increased risk of infections.
People with psoriatic arthritis may be prescribed corticosteroids to help control joint pain, swelling, and stiffness. Researchers found that people taking corticosteroids had a two to six times higher risk of some bacterial, viral, and fungal infections than people who weren’t taking these drugs. The researchers noted that the risk depended on the drug dose and a participant’s age and other medical conditions, such as diabetes.
Conventional disease-modifying antirheumatic drugs (DMARDs), such as methotrexate, are common PsA treatments. DMARDs help reduce inflammation and slow the progression of the disease.
Although these medications decrease immune system activity, a study found that among people with inflammatory rheumatic conditions — including psoriatic arthritis — who took methotrexate, only those with rheumatoid arthritis had an increased risk of infections.
However, the risk of infections does increase if you’re taking a biologic medication. Biologics are a type of DMARD that target specific parts of the immune system. Another type of DMARD, called Janus kinase (JAK) inhibitors, can increase the risk of infection.
While these risks might seem concerning, it’s important to know that skipping treatment can lead to joint damage and uncontrolled arthritis symptoms. Your healthcare provider will carefully assess your overall health before starting you on any medication that affects your immune system.
Maintaining a healthy lifestyle is a good preventive strategy for warding off infections, whether or not you have psoriatic arthritis. Healthy lifestyle suggestions include:
If you have psoriatic arthritis, you might wonder how the flu vaccine could affect your immune system. Doctors recommend that people living with psoriatic arthritis — and others with rheumatic diseases — get vaccinated against influenza each year.
Because many medications for psoriatic arthritis weaken the immune system, it’s especially important to protect yourself from infections like the flu. The American Medical Association recommends that everyone older than 6 months receive a yearly influenza vaccine.
For people living with PsA who take medications that affect the immune system, doctors recommend getting a flu shot — the injected form of the flu vaccine. The injected vaccine contains an inactive (killed) form of the virus, while the nasal spray version uses a live but weakened virus. Live-virus nasal spray vaccines can be unsafe for people with weakened immune systems.
Some psoriatic arthritis treatments can suppress or alter your immune function, which may increase your susceptibility to certain infections — not just the flu. It’s a good idea to get vaccinated with nonlive vaccines for other types of infections, such as pneumonia and shingles. In the U.S., only the nonlive version of the shingles vaccine is available.
Your doctor can help you understand which vaccines you need, based on factors like your previous vaccine history, other illnesses you may have, your age, and more. “I am awaiting my doctor’s go-ahead with the recommended vaccines,” a MyPsoriasisTeam member wrote.
On MyPsoriasisTeam, people share their experiences with psoriasis and psoriatic arthritis, get advice, and find support from others who understand.
Do you have psoriatic arthritis and worry about your risk of infections? Let others know in the comments below.
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