你一步一步的PsA治疗时间表

在巴尔的摩的约翰霍普金斯关节炎中心银屑病关节炎计划主任Ana-Maria Orbai表示，没有人能够为每个人提供哪些治疗。医生通常推荐一线药物，取决于疾病严重程度，然后在那些不削减它时尝试更新，更昂贵的选择。这部分是因为健康保险不会批准一些药物，除非患者首先失败，斯坦福·斯坦福·保健在帕洛阿尔托，加利福尼亚州斯坦福医疗保健的风湿病学家。科学证据和先例的因素也是如此。您的风湿病学者可能会使用以下步骤的一些版本来指导您的治疗方法。

In addition to the obvious aims of slowing PsA progression and reducing pain to a level that allows you to put the disease in the background, many people have goals unique to their situation. For example, maybe you want to take a job that seems too challenging right now because of one specific symptom you can’t shake. Maybe you have other hopes outside of treatment, like getting pregnant, that will impact the meds you can take over the next few years. Communicate your goals to your doctor upfront so you’re starting on the same page.

因为它可以改变，不断重新评估疾病的严重程度是很重要的。在采摘或改变治疗之前，您的医生将想确定您的PSA是否目前是轻度，中等或严重。他们会问：“你认为你的PSA是多么活跃于最近的过去？”Shoor博士说，衡量严重程度。他们还将进行体检，计算招标或肿胀的关节数。其他症状，如整个数字的严重肿胀（称为dactylitis.) or severe tendonitis can also indicate more severe disease, Dr. Shoor says.

所知最重要的是：“你有选择，”呼道博士说。有许多不同的PSA药物可用于根据严重程度治疗疾病。每种药物都以不同的方式在身体上运作，所以如果一个人对你有多好，你的医生可以规定别的东西可能更适合。主要的types of medications used in PsA treatment是非甾体抗炎药（NSAIDS），疾病改性抗炎药物（DMARDS），生物学和新的口服药物。可以短期使用皮质类固醇来治疗坏斑点。

Another important factor to take into account is whether a certain treatment is safe and recommended to take with any other health conditions you have. Certain medications are not OK for certain comorbidities—for example, a few biologic drugs may exacerbate irritable bowel disease (IBD). Others may require special monitoring. While other aspects of your health may seem unimportant when you’re trying to get PsA treatment sorted out, it’s really important to get a full picture of your health and work with your doctor to make sure any new treatments are safe, all things considered.

Never underestimate the impact your daily health choices can have, especially when paired with medication. Dr. Shoor says that after discussing treatment options with patients, he then discusses what they can do on their own in tandem. Most people with a chronic condition want to do whatever they can to improve their condition and quality of life, and making changes in diet, exercise, and stress management can help make a difference.其他补救措施像热浴，蜡疗法和按摩一样，也可以帮助您找到一些缓解。

If treatment is working, you should see an improvement in symptoms in three months, Dr. Orbai says. Yes, that long. The reason is that by the time PsA is symptomatic and diagnosed, the immune system is revved up significantly, so it takes some time for the drugs to catch up, she explains. “If there’s no improvement at about three months, that means it’s probably not a good match for you.” At that time, you and your doctor will go back to the drawing board and try something different to see if you respond to it better.

If a medication is improving your PsA, it’s important to also consider the cost. Does it cause intolerable side effects? Do you have a hard time taking it as prescribed because of the frequency or form (self-injection, for example)? Is it draining your bank account? These are all good reasons to talk with your doctor. Also, some medications can quietly impact other aspects of your health, like liver enzyme levels. An important function of your rheumatologist visits is to make sure your treatment isn’t only working, but that it’s also not causing you any harm, Dr. Orbai says.

管理PSA是一个终身过程。由于副作用和功效可以改变，需要不断评估治疗。例如，奥布莱博士说，生物学通常只有几年的有效。“很少见到生物学将永远有效。”一种可能的原因是人可以对药物进行抗体。与您的觉得和开放的沟通与您的医生一起保持调整是让您的治疗尽可能多的最佳方式。