Many people have vastly improved outcomes from the treatment of PsA with the help of biologics. These medications can increase the risk of adverse events during surgery, pregnancy, and other life events.

The return of PsA symptoms can be caused by stopping a biologic. A number of factors can help you decide if it is right to stop or pause your medication.

PsA causes inflammation in the joints. The severity of the symptoms affects the treatment of PsA. NSAIDs, like ibuprofen, are over-the-counter medications that are first-line medications for mild PsA.

If first-line treatment is not effective, a doctor may recommend a class of drugs called disease-modifying antirheumatic drugs.

Immune system inflammation can be reduced by using biologics, which target specific parts of the immune system. The immune system is more affected by conventional DMARDs.

If conventional options have not helped you reach your goals, you might consider a biologic. If you have moderate to severe PsA, you may look into a biologic.

There are two main types of biologics used to treat PsA, each with a unique target and with its own benefits and risks.

  • Tumor necrosis factor-a (TNF) inhibitors: Adalimumab (Humira), certolizumab pegol (Cimzia), etanercept (Enbrel), golimumab (Simponi), and infliximab (Remicade)
  • Interleukin inhibitors: Ixekizumab (Taltz), secukinumab (Cosentyx), guselkumab (Tremfya), risankisumab-rzaa (Skyrizi), and ustekinumab (Stelara)

B cell inhibitors like rituximab and abatacept are examples of other classes of biologics that may or may not have a role in the treatment of PsA.

A treatment plan that includes a biologic along with a conventional DMARD may be recommended by some doctors.

Treatments that use biologics are generally safe and effective. They can leave the body vulnerable to infections and have other side effects, because of how they affect the immune system. When the risks outweigh the benefits, you may stop your treatment.

It is possible that it is time to take a break.

Pregnancy or breastfeeding

A 2015 review found that there’s been little research into the effects of biologics during pregnancy and breastfeeding. The American College of Rheumatology recommends stopping some kinds of biologic treatments during gestation and lactation.

Diagnosis of a new medical condition

Treatment for some conditions, such as cancer or diabetes, can increase your risk of infection. If you receive a new diagnosis, your doctor might suggest you stop using a biologic for PsA.

Plans to undergo surgery

There is a risk of infections during surgery. If you are about to have a procedure, your doctor may discuss a plan to pause your biologic prior to the event and during your recovery.

Receiving vaccinations

Some vaccines have live virus that can be dangerous to people taking drugs. The vaccines include the yellow fever, the smallpox, and the mumps.

It is a good idea to talk with your doctor about your vaccinations and treatment.

It is recommended that you get vaccinations against common infections such as flu, pneumococcus pneumonia, shingles, and COVID-19 before starting your vaccine regimen.

“Taking into account prior vaccine history and what they may be at risk for, each individual’s vaccine recommendations should be tailored to their specific needs.”

Moving to certain regions

There is a higher risk of histoplasmosis in the Ohio and Mississippi River Valley. If you are going to relocate to any of these areas, you may want to discuss your treatment options.

Low disease activity

Even after you have achieved minimal or low disease activity, most doctors recommend continuing with a biologic treatment. People experience a later flare if treatment stops.

If you stopped a biologic, you can experience a flare if you had achieved remission.

A 2017 paper reviewed the success of dosing down, or reducing the dose, of biologics in people with rheumatic disease. It cited previous research that of those who had discontinued TNF therapy for PsA after remission, 44.9% relapsed in a median time of 29.2 months.

A 2021 double-blind study found that people with PsA who achieved remission with ixekizumab relapsed more quickly if the biologic was withdrawn instead of continued.

If you stop taking your drug, you may no longer experience the side effects. The medication can not work if you stop and start a biologic.

It may be a reasonable option for some life events, like pregnancy or surgery, because you may have a lower risk of infections.

Your doctor can help you figure out what options are available. If your biologic stops working, you can switch to a different one.

If you are considering stopping your treatment, you should talk to your doctor. Some questions people might ask.

  • Can I change my treatment to increase efficacy or reduce side effects?
  • Is it possible to take my biologic if I get pregnant?
  • How long before surgery should I stop taking my medication?
  • When can I get my vaccinations?
  • Can I return to treatments that are not related to disease?
  • Is it possible to reduce or reduce my dose if I achieve a good outcome?

It is a good idea to talk to your doctor whenever you have questions about your medication, so you can decide on the best treatment plan for you.

People often ask about the treatments for psoriatic arthritis.

Can psoriatic arthritis go into remission without medication?

A combination of medications is the most common way to achieve remission. NSAIDs are used to control inflammation even if you have mild PsA.

How long do you stay on biologics for psoriasis?

People stay on a biologic for as long as it works. It is safe to use a biologic indefinitely.

Can I go back on biologics after stopping them?

You can restart a biologic after stopping. If a person takes their medication continuously, it will work best, as stopping and restarting the medication can lead to reduced effectiveness.

Drugs made from biologics are generally safe and effective. Stopping a medication can cause the return of PsA flares.

When the risks outweigh the benefits, you and your doctor may stop the drug.