For many people, injectable medications are a good option for treating psoriatic arthritis (PsA). These types of medications can ease the symptoms of PsA and help prevent further disease progression and joint damage. Injection technology has improved a lot in recent years, leading to new options that make injection easier and more convenient.

Injectable Medications for Psoriatic Arthritis

Injected medications used for PsA include methotrexate, corticosteroids, and a variety of biologic drugs. Many of these treatments are also used to treat psoriasis.

Methotrexate

Methotrexate is a disease-modifying antirheumatic drug (DMARD) used to treat PsA and slow disease progression. Methotrexate is available as tablets, but the injectable form may be more efficient and may prevent certain side effects, such as nausea. Methotrexate is available in vials, prefilled syringes, and autoinjectors.

Corticosteroids

Corticosteroids can be injected directly into an achy joint to help provide quick, short-term relief from joint pain, swelling, and stiffness. These injections are typically given by a health care provider.

Biologics

Many PsA flare-ups can be caused by excess levels of certain types of proteins called cytokines. These inflammatory cytokines include tumor necrosis factor-alpha (TNF-alpha) and the interleukins (ILs) IL-12, IL-17, and IL-23. Injectable biologic medications for PsA reduce inflammation by blocking these cytokines’ effects. Each biologic drug targets a specific cytokine.

Another type of biologic medication for PsA is a T-cell inhibitor. This medication works by blocking the formation of immune cells that trigger cytokine production.

TNF-Alpha Inhibitors

TNF-alpha inhibitors are biologics that help reduce inflammation by blocking TNF-alpha. The following medications are injected subcutaneously (under the skin) and are approved by the U.S. Food and Drug Administration (FDA) for psoriatic arthritis:

• Adalimumab (Humira) — Available in prefilled syringes and autofilled injectors
• Certolizumab pegol (Cimzia) — Available in prefilled syringes
• Etanercept (Enbrel) — Available in prefilled syringes, autofilled injectors, and vials
• Etanercept-szzs (Erelzi) — Available in prefilled syringes and autofilled injectors
• Golimumab (Simponi) — Available in prefilled syringes and autofilled injectors

Interleukin Inhibitors

The following FDA-approved IL inhibitors are given through subcutaneous injections:

• Bimekizumab-bkzx (Bimzelx) — An IL-17A and IL-17F inhibitor available in prefilled syringes and autoinjectors
• Guselkumab (Tremfya) — An IL-23 inhibitor available in prefilled syringes and autofilled injectors
• Ixekizumab (Taltz) — An IL-17 inhibitor available in prefilled syringes and autofilled injectors
• Risankizumab-rzaa (Skyrizi) — An IL-23 inhibitor available in prefilled syringes and autoinjectors
• Secukinumab (Cosentyx) — An IL-17 inhibitor available in prefilled syringes and autofilled injectors
• Ustekinumab (Stelara) — An IL-12 and IL-23 inhibitor available in vials and prefilled syringes

T-Cell Inhibitor

Abatacept (Orencia), available in prefilled syringes and autofilled injectors, is approved to treat PsA and is administered through subcutaneous injection.

Biosimilars

A biosimilar is highly similar to the previously approved biologic medication (referred to as the reference product) but often more affordable. Biosimilars are used to treat psoriasis in the same way as their reference biologics but at a lower cost. Several biosimilars are on the market.

What Is a Subcutaneous Injection?

Many PsA medications are administered through subcutaneous injection. These drugs are injected through a needle and into subcutaneous fat (a layer of fat that’s underneath the skin), which allows the body to absorb the medication slowly and gently.

Subcutaneous injections are usually given in areas of the body that have wide layers of fat, such as the upper arm, thigh, or abdomen. You may be able to do subcutaneous injections at home, or you can book an appointment with your health care provider to receive an in-office injection.

Forms of Injection

Most PsA medications have different dosing options, such as prefilled syringes and autoinjectors, so you can give yourself the injections. The prefilled syringe allows you to control the speed of the injection, while the autoinjector (which usually looks like a large pen) hides the needle and works with the click of a button. A few PsA medications are available in freestanding vials. Using vials allows you to fill your syringe but also requires more injection expertise.

PsA medication injections are different from infusions, which are administered intravenously (directly into a vein). Unlike injections, infusions require an IV bag and a visit to a doctor’s office or an infusion center. PsA medications given by infusion include:

• Golimumab (Simponi Aria)
• Infliximab (Remicade)
• Infliximab-dyyb (Inflectra)

Tips for Administering PsA Injections

Your health care provider can train you to use a prefilled syringe or autoinjector. In addition, many pharmaceutical companies provide detailed guides on how to self-administer injections for their PsA medications, including written instructions, online videos, or telehealth training sessions.

Gather Your Supplies

The injection technique depends on whether you use a syringe or an autoinjector. For either option, make sure to have everything you need before starting the injection process. These materials include:

• Either an alcohol pad or rubbing alcohol on a cotton ball
• Your syringe or autoinjector
• Cotton gauze and an adhesive strip for after the injection
• A sharps container

Sharps containers are designed to keep used needles from injuring other people. You can buy these inexpensive containers online. Some pharmaceutical companies provide a free sharps container along with your prescription. You can typically get rid of a full sharps container through your local pharmacy, doctor’s office, hospital, or hazardous waste site. Some sharps containers can be mailed to a collection site for a fee.

Choose the Right Location

Avoid injecting medication into areas of skin that are tender, bruised, discolored, hard, or affected by psoriatic symptoms. Also, avoid injecting into scarred areas or stretch marks. The best places for subcutaneous injection are often the outer thighs (sometimes called the saddlebags), the abdomen, or the arms.

The abdomen can be a good option unless you’re very thin. Inject below your ribs and above your hips, staying at least 2 inches away from your belly button.

If someone else is administering your injection, you may prefer the upper arm. Your helper should inject 3 inches above the elbow and 3 inches below the shoulder on the side or back of the arm. Don’t try to inject your own arm.

Clean and Sterilize

Before you inject, make sure the injection area is sterile. Wash your hands, and use rubbing alcohol to clean the area that will receive the injection. Let the alcohol dry.

Switch It Up

Avoid using the same area of your body repeatedly. Inject at least 1.5 inches away from your previous injection site, and consider keeping a diary to track locations and help you remember your last injection spot.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and psoriatic arthritis. On MyPsoriasisTeam, more than 131,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis and psoriatic arthritis.

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