Stopping psoriatic arthritis drugs may cause flare-ups

People with psoriatic arthritis (PsA) may want to stop taking their disease-modifying drugs if they experience side effects, or if their PsA seems to have improved. But research suggests that’s a bad idea. Going off these medications could bring symptoms like pain and stiffness back—often within a short period of time.

Understanding PsA

As many as 30 percent of people with the skin condition psoriasis also develop PsA, an autoimmune disease where the body’s immune system attacks the joints, causing pain, swelling, stiffness, and potential damage.

Some people with PsA have only mild symptoms with occasional flare-ups, while others have severe, continuous pain. Regardless of the severity of symptoms, treatment, especially early in the disease, can help prevent joint damage. Not treating psoriatic arthritis can cause joints to become permanently deformed and lead to long-term discomfort and disability.

How PsA medication works

Disease-modifying medications—such as traditional disease-modifying antirheumatic drugs (DMARDs) and biologics—can provide relief from PsA symptoms because they are designed to slow or stop disease activity. For example, methotrexate can help block your immune system from attacking healthy cells in your skin and joints. Other medications called TNF inhibitors work to stop proteins responsible for causing inflammation.

When medications are effective and a person has little-to-no disease activity, it’s called remission. Remission can be long-lasting and greatly improve quality of life. But a significant number of people with PsA stop taking medication, which places remission in jeopardy.

Some people stop because they experience unpleasant side effects, such as:

• Fatigue
• Digestive issues
• Increased infection risk
• Increased risk of developing other serious health conditions, such as heart and lung issues

Other people with PsA stop taking medication because they’re already in remission. They may believe they’re cured, since they haven’t experienced symptoms in some time. Still others may have issues with cost, access, or convenience.

It’s important to understand, however: Though some people with PsA stay in remission after stopping medications, the vast majority do not. In fact, people with PsA who stop taking biologics or targeted synthetic DMARDs are “very unlikely” to achieve sustained remission, according to a 2025 study published in Annals of the Rheumatic Diseases. Many will experience PsA symptoms again, often within a few months.

What to do

If you’d like to stop taking a PsA medication, speak with a healthcare provider (HCP) first. If you’re experiencing side effects, they may switch your medication or change your dosage. If you are in sustained remission, tapering—when an HCP gradually reduces the amount of medication you take—is often recommended. An HCP can also help if medication price or accessibility becomes an issue.

Never come off a drug without your HCP’s explicit endorsement. You may experience side effects, flare-ups, or complications. An HCP can help you determine your best—and most painless—path forward.