Injecting medication at home can seem daunting, but it doesn’t have to be. If your doctor has prescribed Yuflyma for your condition, such as rheumatoid arthritis, psoriasis, uveitis or Crohn’s disease, this comprehensive guide on how to inject Yuflyma at home will walk you through every step with clarity and confidence.
What is Yuflyma?
Yuflyma® (adalimumab-aaty), which you may be preparing to administer, is not just a standard therapeutic agent; it is, in fact, a biosimilar medication. As a biosimilar, it is highly similar to an existing biological medication, known as the ‘reference product’, which in this case is adalimumab, marketed under the brand name Humira®. Extensive comparison through analytical studies has shown that Yuflyma matches its reference in terms of potency, safety, and efficacy.
Despite the similarities, it is important to note that biosimilars are not labeled as “generic” versions of biologic medications because biologics are derived from living cells and are inherently complex, and it is impossible to create an exact copy. Rest assured, before approval, Yuflyma has gone through rigorous regulatory pathways to confirm that it is as safe and efficacious as the original biologic.
Preparing for Your First Self-Injection
Excited? Maybe a little nervous? Totally normal feelings when you’re about to take charge of your health in a hands-on way.
How to Inject Yuflyma at Home – Starting Steps
Clean Workspace: First thing’s first—find yourself a clean, well-lit area to prepare.
Hand Hygiene: Wash your hands with soap and water. It’s simple, but it’s one of the most effective ways to prevent infection.
Gather Supplies: Get your Yuflyma pre-filled syringe or pen, alcohol wipes, cotton balls, and a sharps container for disposal.
Storage Savvy: Remember, Yuflyma should be stored in the refrigerator. If it’s too cold to the touch, let it sit out for 30 minutes to reach room temperature. Never use a microwave or hot water to warm it.
Step-by-Step Injection Guide
Here’s the meat and potatoes of what you came for—how to inject Yuflyma at home:
Check It: Inspect your Yuflyma. It should be clear, and colorless to slightly yellow. If it’s cloudy or has particles, don’t use it.
Skin Selection: Choose your injection spot—either the front of your thighs or your belly, avoiding the waistline and staying two inches clear of the navel.
Clean Up: Swipe the selected area with an alcohol wipe and let it air dry.
Get Grip-Ready: Hold the pen firmly. Remove the needle cover when you’re set to go.
Pinch an Inch: With your free hand, gently pinch the skin around the injection site.
Needle in, Steady: Press the pen firmed onto your pinched skin at 90-degree angle.
Plunge with Confidence: Press the plunger down and steadily until all the medication is injected. It typically take 10 to 15 seconds.
Release and Withdraw: Let go of your skin. Pull the needle out while keeping it at the same angle it went in.
Praise and Press: Give yourself a little internal high-five for a job well done. Place a cotton ball over the site and apply pressure for a bit. If there’s bleeding, that’s okay. Just keep the pressure on a little longer.
Sensible Disposal: Don’t recap the needle. Pop it straight into the sharps container. Of note, Yufyma does have a free sharp container delivery service to your home as well as free returns.
Doesn’t sound too tricky, right? Remember, practice makes perfect.
Common Concerns
Feeling some nerves approach as the injection day circles on your calendar? It’s totally okay.
What About Side Effects?
Yuflyma, like any medication, can come with side effects, including:
Injection site reactions
Upper respiratory infections
Headaches
Rash
For a complete list, always refer to the medication guide provided with your prescription as well as your doctor.
Tips and Tricks for Successful Home Injections
Consistency is Key: Stick to a routine. Consistent timing can help make self-injections second nature.
Record Keeping: Keep a diary of your injection sites. This helps in rotating sites and tracking your condition.
Support System: Get your family or friends involved. A support system can offer a helping hand or emotional backing.
In Conclusion: Empower Yourself
Learning how to inject Yuflyma at home is a commitment to your well-being and health autonomy. Even though administering your injection might feel overwhelming at first, with each little push of the plunger, you’ll become more adept and confident in your ability to manage your treatment.
Call to Action: Take the First Step
Every journey begins with a single step — your health journey is no different. If you’ve been prescribed Yuflyma, start by discussing your treatment plan in-depth with your healthcare provider. Once you’re ready, gather your courage (and your supplies!) and take charge of your health, one injection at a time.
Medical Disclaimer
This information is offered to educate the general public. The information posted on this website does not replace professional medical advice but for general information purposes only. There is no Doctor – Patient relationship established. We strongly advised you to speak with your medical professional if you have questions concerning your symptoms, diagnosis, and treatment.
This information is offered to educate the general public. The information posted on this website does not replace professional medical advice, but for general information purposes only. There is no Doctor – Patient relationship established. We strongly advise you to speak with your medical professional if you have questions concerning your symptoms, diagnosis, and treatment.
Injecting medication at home can seem daunting, but it doesn’t have to be. If your doctor has prescribed Hyrimoz for your condition, such as rheumatoid arthritis, psoriasis, uveitis or Crohn’s disease, this comprehensive guide on how to inject Hyrimoz at home will walk you through every step with clarity and confidence.
What is Hyrimoz?
Hyrimoz® (adalimumab-adaz), which you may be preparing to administer, is not just a standard therapeutic agent; it is, in fact, a biosimilar medication. As a biosimilar, it is highly similar to an existing biological medication, known as the ‘reference product’, which in this case is adalimumab, marketed under the brand name Humira®. Extensive comparison through analytical studies has shown that Hyrimoz matches its reference in terms of potency, safety, and efficacy.
Despite the similarities, it is important to note that biosimilars are not labeled as “generic” versions of biologic medications because biologics are derived from living cells and are inherently complex, and it is impossible to create an exact copy. Rest assured, before approval, Hyrimoz has gone through rigorous regulatory pathways to confirm that it is as safe and efficacious as the original biologic.
Preparing for Your First Self-Injection
Excited? Maybe a little nervous? Totally normal feelings when you’re about to take charge of your health in a hands-on way.
How to Inject Hyrimoz at Home – Starting Steps
Clean Workspace: First thing’s first—find yourself a clean, well-lit area to prepare.
Hand Hygiene: Wash your hands with soap and water. It’s simple, but it’s one of the most effective ways to prevent infection.
Gather Supplies: Get your Hyrimoz pre-filled syringe or pen, alcohol wipes, cotton balls, and a sharps container for disposal.
Storage Savvy: Remember, Hyrimoz should be stored in the refrigerator. If it’s too cold to the touch, let it sit out for 30 minutes to reach room temperature. Never use a microwave or hot water to warm it.
Step-by-Step Injection Guide
Here’s the meat and potatoes of what you came for—how to inject Hyrimoz at home:
Check It: Inspect your Hyrimoz. It should be clear, and colorless to slightly yellow. If it’s cloudy or has particles, don’t use it.
Skin Selection: Choose your injection spot—either the front of your thighs or your belly, avoiding the waistline and staying two inches clear of the navel.
Clean Up: Swipe the selected area with an alcohol wipe and let it air dry.
Get Grip-Ready: Hold the pen firmly. Remove the needle cover when you’re set to go.
Pinch an Inch: With your free hand, gently pinch the skin around the injection site.
Needle in, Steady: Press the pen firmed onto your pinched skin at 90-degree angle.
Plunge with Confidence: Press the plunger down and steadily until all the medication is injected. It typically take 10 to 15 seconds.
Release and Withdraw: Let go of your skin. Pull the needle out while keeping it at the same angle it went in.
Praise and Press: Give yourself a little internal high-five for a job well done. Place a cotton ball over the site and apply pressure for a bit. If there’s bleeding, that’s okay. Just keep the pressure on a little longer.
Sensible Disposal: Don’t recap the needle. Pop it straight into the sharps container. Of note, Hyrimoz does have a free sharp container delivery service to your home as well as free returns.
Doesn’t sound too tricky, right? Remember, practice makes perfect.
Common Concerns
Feeling some nerves approach as the injection day circles on your calendar? It’s totally okay.
What About Side Effects?
Hyrimoz, like any medication, can come with side effects, including:
Injection site reactions
Upper respiratory infections
Headaches
Rash
For a complete list, always refer to the medication guide provided with your prescription as well as your doctor.
Tips and Tricks for Successful Home Injections
Consistency is Key: Stick to a routine. Consistent timing can help make self-injections second nature.
Record Keeping: Keep a diary of your injection sites. This helps in rotating sites and tracking your condition.
Support System: Get your family or friends involved. A support system can offer a helping hand or emotional backing.
In Conclusion: Empower Yourself
Learning how to inject Hyrimoz at home is a commitment to your well-being and health autonomy. Even though administering your injection might feel overwhelming at first, with each little push of the plunger, you’ll become more adept and confident in your ability to manage your treatment.
Call to Action: Take the First Step
Every journey begins with a single step — your health journey is no different. If you’ve been prescribed Hyrimoz, start by discussing your treatment plan in-depth with your healthcare provider. Once you’re ready, gather your courage (and your supplies!) and take charge of your health, one injection at a time.
Medical Disclaimer
This information is offered to educate the general public. The information posted on this website does not replace professional medical advice but for general information purposes only. There is no Doctor – Patient relationship established. We strongly advised you to speak with your medical professional if you have questions concerning your symptoms, diagnosis, and treatment.
HLA-B27 is a gene that provides instructions for making a protein called major histocompatibility complex, class I, B 27 (MHC Class 1 B 27). This protein plays an important role in the immune system by presenting antigens to T-cells. Approximately 6-8% of the general population carries the HLA-B27 gene, though prevalence varies among different ethnic groups. HLA-B27 positivity is closely associated with a group of inflammatory joint conditions known as seronegative spondyloarthropathies. The most well-known of these is ankylosing spondylitis, where up to 90% of patients test positive for HLA-B27. Other associated conditions include reactive arthritis, psoriatic arthritis, inflammatory bowel disease, and acute anterior uveitis. While the exact mechanism is unclear, it is believed that HLA-B27 may present self-antigens to T-cells, triggering an autoimmune response that leads to chronic inflammation in the joints and eyes.
HLA-B27 and the Eye
The main ocular manifestation of HLA-B27 is uveitis, which is inflammation of the middle layer of the eye called the uvea. Up to 50% of cases of acute anterior uveitis are associated with HLA-B27. Although HLA-B27 is strongly linked to acute anterior uveitis, which involves the iris and ciliary body, it can also be associated with intermediate, posterior and panuveitis.
The exact mechanism for how HLA-B27 leads to increased uveitis risk is not fully understood. One theory is molecular mimicry, where HLA-B27 is similar in structure to molecules found in the eye, leading to cross-reactivity of the immune system. Another theory suggests HLA-B27 misfolds and elicits an inflammatory response. Regardless of the mechanism, HLA-B27 positive individuals have a greatly increased lifetime risk for developing recurrent uveitis.
Types of HLA-B27 Uveitis
The most common type of uveitis associated with HLA-B27 is acute anterior uveitis, which involves inflammation of the iris and ciliary body in the front of the eye. Up to 50% of all cases of acute anterior uveitis are linked to HLA-B27 positivity [1]. Anterior uveitis leads to redness, pain, and blurred vision.
While anterior uveitis is most typical, HLA-B27 positive individuals can also develop inflammation involving the posterior segment of the eye, including intermediate uveitis, posterior uveitis, and panuveitis [2]. Posterior inflammation is less common but can lead to more severe visual complications if not treated promptly.
Symptoms of HLA-B27 Uveitis
The most common symptoms of HLA-B27 associated uveitis are:
Acute onset of redness in one eye
Eye pain and discomfort, often severe
Blurred vision or reduced visual acuity
Photophobia or increased sensitivity to light
Tearing and discharge
Patients often describe a sudden onset of symptoms including severe pain, redness, and light sensitivity in one eye. Vision becomes blurred or cloudy. Discharge and tearing may occur as inflammation sets in. The symptoms arise rapidly and reach peak intensity over the course of a few days. Attacks often recur periodically in the same eye.
The acute anterior uveitis associated with HLA-B27 has a classic presentation but posterior uveitis involving the retina or choroid can also occur. Symptoms help differentiate anterior versus posterior inflammation. Vision loss, floaters, and photopsias point more to posterior segment issues.
In summary, the typical symptoms of HLA-B27 uveitis are unilateral red eye with blurred vision, pain, and tearing. The acute onset and recurrent nature helps differentiate it from other types of uveitis. Prompt diagnosis and treatment is key to prevent complications from repeated bouts of inflammation.
Diagnosis
Diagnosing HLA-B27 uveitis involves a comprehensive eye examination, medical history assessment, and laboratory tests. Ophthalmologists may use several methods to evaluate the type and severity of uveitis:
Slit lamp exam – This allows close inspection of the front structures of the eye. Signs of inflammation in the anterior chamber such as flair and inflammatory cells can be observed. The architecture of the iris and lens are also examined for abnormalities.
Intraocular pressure measurement – Increased pressure may indicate inflammation of the trabecular meshwork or steroid response. Low pressure can occur with severe inflammation.
Dilated pupil exam – Drops are used to open up the pupil so the ophthalmologist can thoroughly inspect the posterior segment with an ophthalmoscope. Active inflammation of the retina or choroid may be visible.
Optical coherence tomography (OCT) – This non-invasive imaging technique can reveal subtle changes in the retina and measure areas of macular edema.
Fluorescein angiography – A dye injected into the arm travels to the blood vessels in the eye. This allows detailed visualization of retinal vasculitis, vascular leakage, and macular edema.
Lab tests – HLA-B27 blood testing confirms the genetic marker. Complete blood count, inflammatory markers, syphilis testing, and x-rays may be ordered to rule out other potential causes of uveitis.
Treatment
Treatment for HLA-B27 uveitis focuses on controlling acute flare ups and preventing recurrent episodes of inflammation. The main treatments include:
Topical corticosteroid eye drops such as prednisolone or dexamethasone are used to rapidly decrease inflammation and symptoms during an acute attack. High potency drops may be given frequently (up to every hour) upon onset of a flare up.
Immunomodulatory medications can be used to reduce the body’s autoimmune response and prevent recurrent episodes of uveitis. Common options include methotrexate, mycophenolate mofetil, cyclosporine, and newer biologic agents like adalimumab or infliximab. These are often used along with low-dose corticosteroid drops to maintain remission.
According to research, “Treatment for HLA-B27 uveitis can range from local corticosteroids to immunosuppressive drugs, and now numerous studies have highlighted the benefits of tumor necrosis factor alpha inhibitors in the management of HLA-B27-associated uveitis” (Source)
The treatment plan is tailored to the individual patient based on the severity and recurrence pattern of their inflammation. The goal is to find the lowest effective doses needed to control the uveitis long-term.
During monitoring exams, the ophthalmologist will perform a slit lamp exam to carefully inspect the anterior chamber for signs of recurrent inflammation. Intraocular pressure will also be checked to screen for steroid-induced glaucoma. Dilated fundus exam and optical coherence tomography may be done to check for cystoid macular edema and other posterior segment complications. Patients are instructed to contact their ophthalmologist immediately if symptoms of recurrent uveitis flare up between scheduled visits.
Regular monitoring aims to achieve quiescence of inflammation and prevent permanent vision loss from complications. Studies show that 60-90% of patients respond well to proper management and maintain 20/20 visual acuity long-term. However, ongoing adherence to treatment and follow-up care is imperative.
Complications
Chronic inflammation due to HLA-B27 uveitis can lead to several complications that threaten vision and eye health. The most common complications include:
Posterior Synechiae
Up to 40% of patients develop posterior synechiae, which are adhesions between the iris and lens [1]. These adhesions can permanently damage the drainage system and cause angle closure glaucoma.
Cataract
Around 20% of HLA-B27 uveitis cases result in cataract formation, particularly with repeated inflammation [2]. Cataracts cause blurred vision and eventual blindness if left untreated.
Glaucoma
Increased eye pressure is common in HLA-B27 uveitis. Glaucoma develops in up to 10% of patients and can lead to optic nerve damage and vision loss if uncontrolled [3].
Cystoid Macular Edema (CME)
Chronic inflammation can also result in CME, which is fluid accumulation in the macula causing blurred central vision. Regular eye exams are key to detecting CME early.
Prognosis
With timely diagnosis and proper management of HLA-B27 associated uveitis, the prognosis for vision is generally good. Studies show that with consistent steroid and immunomodulatory treatment to control inflammation, most patients can maintain useful vision and experience minimal complications.
According to a 10-year study published in Ocular Immunology and Inflammation, 95% of HLA-B27 positive uveitis patients achieved complete remission or only rare episodic inflammation when treated with systemic immunosuppression along with steroid eye drops. The study concluded that recurrent HLA-B27 anterior uveitis responds well to therapy and monitoring.
Patients need to work closely with their ophthalmologist for regular exams and screenings to detect recurrences early. With vigilant monitoring and treatment compliance, most can retain 20/20 vision despite having a chronic uveitis condition.
Conclusion – the importance of recognizing HLA-B27 uveitis and controlling inflammation
HLA-B27 associated uveitis can lead to significant ocular complications and vision loss if left uncontrolled. However, with prompt diagnosis and proper management, the prognosis for maintaining good vision is favorable. It is critical for both patients and physicians to be aware of the connection between HLA-B27 and uveitis.
Patients who test positive for HLA-B27 should have regular dilated eye exams to screen for signs of uveitis, even in the absence of symptoms. At the first sign of inflammation, aggressive treatment is needed to eliminate active disease and prevent recurring attacks. Though challenging to manage, chronic uveitis in HLA-B27 patients can typically be well-controlled with corticosteroid therapy and secondary immunosuppressive medications as needed.
Close monitoring for elevated eye pressure, cataracts, macular edema and other complications is also essential. Early intervention with surgery may be required in some cases. With a tailored treatment approach and ongoing care, most HLA-B27 positive patients can achieve lasting remission and preserve their vision.
Medical Disclaimer
The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this article is for general information purposes only and does not replace a consultation with your own doctor/health professional
Although other newer biologics are available, methotrexate remains a cornerstone treatment for rheumatoid arthritis today.
When the Shortage Began
The current shortage of methotrexate began in late 2022, according to the American Society of Health-Systems Pharmacists (ASHP). It was primarily caused by manufacturing delays and supply chain issues impacting several major methotrexate suppliers, including Pfizer, Teva, and Fresenius Kabi. This led to intermittent supply disruptions and backorders for both the injectable and oral forms of the drug.
The methotrexate shortage has been further exacerbated by increased demand for the drug during the COVID-19 pandemic. Rheumatoid arthritis patients have been seeking additional prescriptions to manage worsening pain and inflammation while staying home. This spike in demand made the limited supply even more scarce for those dependent on methotrexate.
Expected Duration of the Methotrexate Shortage
The exact end date of the methotrexate shortage is still unclear. Manufacturers have indicated the shortage could potentially last through much of 2023, depending on how quickly they can resolve the underlying manufacturing and supply issues.
According to the American Society of Health-System Pharmacists (ASHP), the shortage is expected to continue through at least June 2023 for injection formulations from suppliers like Fresenius Kabi and Hikma [1]. The timeline is less certain for oral formulations, with some manufacturers like Teva unable to provide estimates on resolution.
Ultimately, the duration of the methotrexate shortage is highly dependent on pharmaceutical companies bringing their manufacturing capabilities back to normal levels. Some progress is being made, with Accord Healthcare restarting production in late 2022 after facility issues [2]. However, until all manufacturers have fully resumed stable methotrexate production and replenished inventory, the shortage is likely to persist.
Impacts on Rheumatology Patients
The methotrexate shortage has had significant impacts on rheumatology patients who rely on the drug to manage their conditions. Many patients are reporting difficulty filling their methotrexate prescriptions as pharmacies face short supply. This forces some patients to skip doses or take smaller doses than prescribed, which can lead to increased joint pain, stiffness, and swelling as their condition flares up. One survey found that 76% of pediatric cancer centers had patients miss or delay methotrexate doses due to the shortage.
In some cases, rheumatology patients may be forced to switch to more expensive biologic drugs instead of methotrexate to manage their symptoms. However, these drugs can cost thousands of dollars per dose, resulting in much higher out-of-pocket medical expenses. The financial strain adds further hardship for patients already dealing with increased joint inflammation and pain from the lack of methotrexate.
Alternatives During the Shortage
With the methotrexate shortage, rheumatology patients and their doctors need to explore alternatives to manage symptoms. Some options include:
Other DMARDs (disease-modifying antirheumatic drugs) like sulfasalazine or leflunomide may be substituted, depending on the patient’s condition. These work in a similar way to methotrexate and can help control inflammatory arthritis.
Biologics like Humira (adalimumab) or Enbrel (etanercept) target specific parts of the immune system. They can be very effective for rheumatoid arthritis but are more expensive.
Corticosteroids like prednisone reduce inflammation and pain quickly. But long-term use can cause side effects, so they are typically used as a bridge until other treatments start working.
Lifestyle measures like rest, exercise, diet, and stress management may also help patients manage symptoms during the shortage. But they should not replace disease-modifying medications.
Ultimately, it is important to have a conversation with your physician to discuss your personalized treatment plan.
Efforts to Resolve the Methotrexate Shortage
There are ongoing efforts to improve the methotrexate supply and end the shortage as soon as possible. Major manufacturers like Teva and Mylan have been working to resolve the issues that led to the shortage at their facilities (source). Teva restarted production at one facility in November 2022, which has helped stabilize the supply somewhat.
The FDA has also worked to increase available supply by reaching agreements to import methotrexate from abroad. The regulatory agency is engaging with manufacturers around the world to facilitate greater imports to meet US demand (source).
In addition, the FDA has allowed compounding pharmacies to help close the gap by producing compounded methotrexate products. While compounded drugs carry greater risk, this temporary measure expands supply while issues limiting manufacturing persist.
Preparing for Future Shortages
To prevent shortages in the future, steps must be taken to improve the resilience of the pharmaceutical supply chain. According to the AMA, diversifying suppliers is key to avoiding disruptions when a single company faces manufacturing issues (AMA, 2023). The FDA also recommends increasing stockpiles and reserves of essential medications that are at risk of shortage (Shuman, 2020). Finally, end-to-end supply chain transparency and information sharing between manufacturers, wholesalers, pharmacies, and regulators can identify potential shortages earlier and mobilize responses (Pharma News Intel, 2023).
By taking a proactive, collaborative approach, the pharmaceutical industry can build a more resilient supply chain and ensure patients have access to vital medications during public health emergencies. Regulators must also be empowered to act quickly when shortages arise to minimize disruptions to patient care.
Conclusion
In summary, the methotrexate shortage that began in late 2022 has had significant impacts on rheumatology patients who rely on this critical medication. Patients have struggled to access their usual methotrexate doses, resulting in increased symptoms and reduced quality of life. Rheumatologists have worked hard to find alternatives, but options are limited. This highlights the importance of ensuring consistent supply and production of key medications.
Solutions require collaboration across the pharmaceutical industry and government regulators. Manufacturing and supply chain improvements are needed to prevent future shortages and ensure access. With luck this shortage will be resolved quickly, but work remains to build a more resilient prescription drug supply system.
There is hope the manufacturers will resolve the issues causing this shortage in the coming months. However, the impacts have shown the vulnerability of relying on just a few suppliers for essential medications. Rheumatology patients and providers will continue advocating for reliable access to the treatments they need.
Medical Disclaimer
This information is offered to educate the general public. The information posted on this website does not replace professional medical advice, but for general information purposes only. There is no Doctor – Patient relationship established. We strongly advised you to speak with your medical professional if you have questions concerning your symptoms, diagnosis
Psoriatic arthritis is a type of inflammatory arthritis that occurs in people with psoriasis, an autoimmune condition affecting the skin. It causes swelling, stiffness and pain in the joints as well as nail changes and overall fatigue.
Psoriatic arthritis can be difficult to diagnose in its early stages but it’s important to identify and treat it quickly. Early treatment helps relieve symptoms, improve quality of life, and potentially slow down the progression of joint damage that can occur if the disease advances untreated.
Joint Pain
One of the most common early symptoms of psoriatic arthritis is persistent joint pain, swelling, and stiffness (Mayo Clinic). This pain often affects the large joints like the knees, ankles, elbows, and wrists, but can also impact smaller joints like those in the hands and feet.
The joint pain of psoriatic arthritis tends to be asymmetric, meaning it occurs on just one side of the body rather than symmetrically on both sides. The pain and stiffness tend to be worse when joints are at rest, and improves with movement. Psoriatic arthritis joint pain may also alternate between periods of flare ups and remission.
It’s important to note that psoriatic arthritis joint pain can occur even in people who do not have skin psoriasis. The joint symptoms may precede the skin lesions in some cases. Persistent joint pain, swelling, and stiffness, especially when asymmetric and alternating between flares and remission, can be an early sign of psoriatic arthritis.
Fatigue
Fatigue is a very common symptom of psoriatic arthritis, with studies showing that up to 80% of people with PsA experience some degree of fatigue (SOURCE). The chronic inflammation associated with PsA can contribute to feelings of tiredness and lack of energy (SOURCE). This type of fatigue is different than normal tiredness after a long day – it is often described as an overwhelming, debilitating exhaustion that affects your ability to perform daily activities.
Psoriatic arthritis fatigue can range from mild to severe. You may feel generally run down or constantly drained. Simple tasks like grocery shopping, cleaning or caring for your family may wipe you out. This fatigue can be mentally exhausting as well, making it hard to concentrate or be productive. Unlike normal tiredness which gets better with rest, psoriatic arthritis fatigue may persist even when you get adequate sleep.
If you are experiencing new, unexplained and persistent fatigue along with other psoriatic disease symptoms like joint pain, stiffness or skin changes, be sure to contact your doctor. Finding the right treatment can help manage inflammation and greatly improve psoriatic arthritis fatigue.
Joint Redness and Warmth
One early symptom that should prompt suspicion of psoriatic arthritis is redness and warmth over the joints, especially when it is confined to one side of the body. Unlike regular aches and pains, the joints affected by psoriatic arthritis often become noticeably red and feel warm to the touch. This occurs when the immune system mistakenly attacks the joints, causing inflammation. According to the Mayo Clinic [“results”][0][“url”]}>, this redness and warmth is a hallmark feature of inflammatory types arthritis like psoriatic arthritis.
Some people first notice the redness and warmth before feeling any arthritic pain or stiffness. The joints most likely to develop redness and warmth are those in the hands, wrists, elbows, knees, ankles and feet. If you notice persistent redness and warmth in these joints, particularly if it is asymmetric and predominately affecting one side, be sure to point this symptom out to your doctor during your appointment. Redness and warmth in your joints in combination with other psoriatic symptoms should prompt referral to a rheumatologist for further evaluation for psoriatic arthritis.
Swollen Fingers/Toes
One early sign of psoriatic arthritis is dactylitis, also known as “sausage digit.” This refers to swelling in the fingers or toes that causes them to appear sausage-like. Dactylitis is caused by inflammation of the tendons and soft tissues of the digits. According to the National Psoriasis Foundation, dactylitis affects roughly 40-50% of people with psoriatic arthritis[1]. It often presents before any joint damage is apparent.
Dactylitis most commonly affects the middle joint of the fingers or toes, though it can occur in the wrist, ankles, and feet as well. The swelling and inflammation is often asymmetric, meaning it appears on just one finger or toe at a time, rather than symmetrically on both sides. Dactylitis causes stiffness, pain, and limited mobility in the affected digits. If you notice sausage-like swelling in your fingers or toes, it is important to see a doctor promptly, as it may be an early red flag for psoriatic arthritis[2].
Nail Changes
Nail changes are a common early sign of psoriatic arthritis. The most frequent nail manifestations are pitting, grooves, and detachment of the nail from the nail bed (onycholysis).
Pitting appears as small depressions or holes in the nail surface and gives the nail a spotted look. These pits are caused by defects in nail growth. Pitting occurs in up to 50% of those with psoriatic arthritis[1].
Nail grooves are furrows or channels that run vertically down the nail. They may be deep or superficial lines. Grooves are present in around 25% of psoriatic arthritis patients[2].
Onycholysis refers to separation of the nail from the nail bed. The nail becomes detached from the skin underneath. This occurs when inflammation damages the nail matrix. Onycholysis is seen in approximately 10-15% of those with psoriatic arthritis[3].
Getting early treatment for psoriatic arthritis can help prevent permanent nail deformities. See a doctor if nail changes accompany joint pains.
Lower Back Pain
Lower back pain is a common symptom of psoriatic arthritis. About 30-50% of people with psoriatic arthritis will experience pain and stiffness in their lower back caused by inflammation of the joints in the spine 1. This is known as axial arthritis or spondylitis. The lower back is commonly affected before other areas of the spine.
Lower back pain from psoriatic arthritis often comes on slowly and worsens over time. It can range from mild to severe. The pain and stiffness tend to be worse in the morning and improve with movement and activity. However, prolonged sitting or standing can also aggravate the pain. Lower back pain from psoriatic arthritis may switch between sides or stay on one side consistently.
If you have lower back pain along with other symptoms of psoriatic arthritis like joint swelling and skin changes, be sure to see a rheumatologist. Getting an early and accurate diagnosis is key to preventing permanent spinal joint damage. Treatment for psoriatic spondylitis aims to relieve pain, improve function, and slow the progression of the disease.
Signs you may be at risk for psoriatic arthritis
If you experience any symptoms of psoriatic arthritis, it’s important to schedule an appointment with your doctor to get an evaluation. The earlier psoriatic arthritis is diagnosed, the better the outcome with treatment. You should see a doctor if you have:
Joint pain, swelling, or stiffness that persists for more than 2 weeks (https://www.mayoclinic.org/diseases-conditions/psoriatic-arthritis/symptoms-causes/syc-20354076)
Redness or warmth over joints
Swollen fingers or toes that look like sausages
Morning joint stiffness lasting over 30 minutes
New pitting, ridges, or separation of the nails (https://www.healthline.com/health/psoriatic-arthritis-early-signs)
Fatigue that is not relieved by rest
Lower back pain, especially with joints affected elsewhere
Don’t dismiss unexplained joint pain or wait and see if it goes away. The sooner psoriatic arthritis can be diagnosed, the better the outcome with early treatment to relieve symptoms and slow disease progression. See a doctor right away if you have psoriasis and develop any joint pain or swelling.
Medical Disclaimer
The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional
