Managing Treatment

Talk to your doctor

A good relationship with your rheumatologist is an important part of treating psoriatic arthritis (PsA). One way to build that relationship is to help your rheumatologist or dermatologist understand your symptoms and the way PsA affects your daily life. When your doctor knows about your symptoms, he or she can decide what treatment is best for you.

By being open and honest with your doctor, you give yourself the best chance of benefiting from your treatment. For example, tell your doctor about your pain, stiffness, skin irritation, and fatigue levels. Mention the treatments you have tried, how long you've taken them, and the results you've had. Writing out your questions in advance will help you have a more focused conversation.

To help you get the most from your appointment, we've created a Psoriatic Arthritis Discussion Guide. Simply download and print the guide, answer the questions, and bring it to your next appointment. Answering these questions will help you discuss your symptoms with your doctor. Together, you can decide if treatment with REMICADE® may be right for you.

Questions for your rheumatologist or dermatologist

Bring your completed Psoriatic Arthritis Discussion Guide to your appointment, and consider asking your doctor the following questions:

  • I have plaque psoriasis, as well as intermittent joint pain and stiffness, especially in my hands/feet/lower back area. Should I be concerned about PsA?
  • At what age should I be concerned about getting PsA?
  • PsA runs in my family. Am I more at risk of developing it?
  • How many times do I have to experience joint and skin symptoms before I am diagnosed with PsA?
  • What would happen if I simply tolerated my PsA symptoms and didn't treat them?
  • What's my diagnosis?
  • What's happening to my body as a result of my PsA?
  • Will the treatment you have selected for me treat both joint and skin symptoms?
  • Am I a candidate for biologic therapy?
  • Can REMICADE® help stop the progression of new joint damage and help me manage joint and skin symptoms?
  • How and when will this treatment make me feel better?
  • What are the benefits and potential side effects of treatment?
  • What should I do if I experience side effects?

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Only your doctor can recommend a course of treatment after checking your health condition. REMICADE® (infliximab) can cause serious side effects such as lowering your ability to fight infections. Some patients, especially those 65 years and older, have had serious infections caused by viruses, fungi or bacteria that have spread throughout the body, including tuberculosis (TB) and histoplasmosis. Some of these infections have been fatal. Your doctor should monitor you closely for signs and symptoms of TB during treatment with REMICADE®.

Unusual cancers have been reported in children and teenage patients taking TNF-blocker medicines. Hepatosplenic T-cell lymphoma, a rare form of fatal lymphoma, has occurred mostly in teenage or young adult males with Crohn’s disease or ulcerative colitis who were taking REMICADE® and azathioprine or 6-mercaptopurine. For children and adults taking TNF blockers, including REMICADE®, the chances of getting lymphoma or other cancers may increase.

You should discuss any concerns about your health and medical care with your doctor.

What should I tell my doctor before I take REMICADE®?

You should let your doctor know if you have or ever had any of the following:

  • Tuberculosis (TB) or have been near someone who has TB. Your doctor will check you for TB with a skin test. If you have latent (inactive) TB, you will begin TB treatment before you start REMICADE®.
  • Lived in a region where certain fungal infections like histoplasmosis or coccidioidomycosis are common.
  • Infections that keep coming back, have diabetes or an immune system problem.
  • Any type of cancer or a risk factor for developing cancer, for example, chronic obstructive pulmonary disease (COPD) or had phototherapy for psoriasis.
  • Heart failure or any heart condition. Many people with heart failure should not take REMICADE®.
  • Hepatitis B virus (HBV) infection or think you may be a carrier of HBV. Your doctor will test you for HBV.
  • Nervous system disorders (like multiple sclerosis or Guillain-Barré syndrome).

Also tell your doctor if you:

  • Use the medicines Kineret (anakinra), Orencia (abatacept) or Actemra (tocilizumab) or other medicines called biologics used to treat the same problems as REMICADE®.
  • Are pregnant, plan to become pregnant, are breast-feeding, or have a baby and were using REMICADE® during your pregnancy. Tell your baby’s doctor about your REMICADE® use before the baby receives any vaccine because of an increased risk of infection for up to 6 months after your last dose of REMICADE® you received during your pregnancy.
  • Recently received or are scheduled to receive a vaccine. Adults and children taking REMICADE® should not receive live vaccines or treatment with a weakened bacteria (such as BCG for bladder cancer) while taking REMICADE®.

What should I watch for and talk to my doctor about before or while taking REMICADE®?

The following serious (sometimes fatal) side effects have been reported in people taking REMICADE®.

You should tell your doctor right away if you have any of the signs listed below:

  • Infections (like TB, blood infections, pneumonia)—fever, tiredness, cough, flu, or warm, red or painful skin or any open sores. REMICADE® can make you more likely to get an infection or make any infection that you have worse.
  • Lymphoma, or any other cancers in adults and children.
  • Skin cancer—any changes in or growths on your skin.
  • Heart failure—new or worsening symptoms, such as shortness of breath, swelling of your ankles or feet, or sudden weight gain.
  • Reactivation of HBV—feeling unwell, poor appetite, tiredness, fever, skin rash and/or joint pain.
  • Liver injury—jaundice (yellow skin and eyes), dark brown urine, right-sided abdominal pain, fever, or severe tiredness.
  • Blood disorders—fever that doesn’t go away, bruising, bleeding or severe paleness.
  • Nervous system disorders—numbness, weakness, tingling, changes in your vision or seizures.
  • Allergic reactions during or after the infusion—hives, difficulty breathing, chest pain, high or low blood pressure, swelling of face and hands, and fever or chills.
  • Lupus-like syndrome—chest discomfort or pain that does not go away, shortness of breath, joint pain, rash on the cheeks or arms that gets worse in the sun. The more common side effects with REMICADE® are respiratory infections (that may include sinus infections and sore throat), headache, rash, coughing and stomach pain.
  • Psoriasis—new or worsening psoriasis such as red scaly patches or raised bumps on the skin that are filled with pus.

Please read the accompanying Medication Guide for REMICADE® and talk with your doctor. You are encouraged to report negative side effects of prescription drugs to the FDA.

Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.