Psoriatic Arthritis: What to Expect When Starting IV Biologics
Health ConditionsRheumatic ConditionsPsoriatic Arthritis

What to Expect When Starting an IV Biologic for Psoriatic Arthritis

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Published on April 13, 2026
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I f you’re having trouble getting psoriatic arthritis (PsA) under control, it may be time to consider a biologic. “Biologics have been life-changing medications for people with psoriasis and psoriatic arthritis,” says Dee Dee Wu, MD, a rheumatologist at Hospital for Special Surgery in Paramus, New Jersey.

Some biologics are given as injections you can administer to yourself at home, while others are given by IV infusion at a clinic or infusion center. According to Bret Sohn, MD, a rheumatologist at Stamford Health Medical Group Rheumatology in Connecticut, people often choose the IV option for several reasons:

  • Fear of Self-Injections Some people feel anxious about injecting the medication at home by themselves.
  • Scheduling Preferences Others prefer having scheduled infusion appointments instead of managing shots at home.
  • Dosing Accuracy Many IV medications are dosed based on weight, which can help ensure you’re getting the amount that’s right for your body.
  • Cost In some cases IV biologics make the most financial sense, as they’re often covered as a medical benefit, rather than a pharmacy benefit, with lower out-of-pocket costs.

If you and your doctor have decided an IV biologic is the right next step, here’s what you can expect before, during, and after infusions.

How to Prepare for Starting an IV Biologic for Psoriatic Arthritis

Work with your rheumatologist to complete these steps before the first infusion:

Treatment Steps

You’ll likely go to an infusion center to receive the prescribed IV biologic for psoriatic arthritis.

IV Biologic Infusion Process

Here’s a step-by-step overview of what to expect:

  1. When you arrive you’ll check in and fill out any necessary paperwork.
  2. Next, a nurse will weigh you, as many IV doses are calculated based on exact body weight. During this time, the nurse will also take your vitals and review information about the medication and its potential side effects.
  3. About 30 minutes before the infusion, you may receive acetaminophen (Tylenol), a steroid, an antihistamine (such as Benadryl), or all three, says Sohn. This may help prevent potential reactions or side effects.
  4. A nurse will insert a small tube into your arm or hand. If you’re nervous, let the nurse know, because they can often help you stay calm.
  5. The medicine will drip slowly, especially for the first infusion. Nurses will check your blood pressure and heart rate frequently to watch for any adverse or allergic reactions.
  6. Depending on the drug and dose, the infusion can take 30 minutes to 4 hours.
  7. Before heading home you’ll stay for another 15 to 60 minutes after the infusion is complete to ensure you feel well and haven’t had any reactions.

What It’s Like During the Infusion

When getting a biologic infusion for psoriatic arthritis, you may experience:

Sensations as the Medicine Enters Your Body

You might feel a cool sensation in your arm or a sense of warmth coming over you as the fluid enters your body. Some people also have heart palpitations as the protein in the medication enters the bloodstream, says Sohn.

Sensations as the Medicine Enters Your Body

Emotional Responses to Your Surroundings

The environment itself can also play a role in how you feel. “You may see a lot happening around you, because there might be other people getting other types of therapies,” says Sohn. “The environment alone may drum up some anxiety.” That’s why a comfort kit can come in handy. You can also lean on mindfulness exercises, such as deep breathing or guided meditation, to help ease stress or anxious thoughts during the infusion.

Emotional Responses to Your Surroundings

Treatment Timeline

Biologic infusions typically unfold over several phases, from your first visit through ongoing maintenance and monitoring. Each stage has a specific purpose, whether it’s building up the dosage, evaluating how well the treatment is working, or keeping psoriatic arthritis under control long term.

Here’s what you can generally expect as you move through the treatment course:

Side Effects of IV Biologics

Receiving a biologic should not be painful, beyond the IV insertion. The most common side effects include:

Real-Life Tips for IV Biologics

Ask the nurses or medical assistants questions beforehand: ‘What will the infusion center look like?’ ‘How many other people will be in there?’ ‘How long will the infusion take?’

— Jeanette Gladstone, 57, Florida, diagnosed with PsA in 2009

— Jeanette Gladstone, 57, Florida, diagnosed with PsA in 2009
Try scheduling your infusion at the end of the week, because these medications usually make people very tired. You could also have brain fog, so make sure you’re not doing anything mentally taxing that weekend.

— Ashley Krivohlavek, 42, Oklahoma, diagnosed with PsA in 2013

— Ashley Krivohlavek, 42, Oklahoma, diagnosed with PsA in 2013
The night before, I do a lot of meditation and listen to calm music — and sometimes take antianxiety medication. It’s really about prepping mentally, telling yourself, ‘I’m going to be fine.’ I think about good things like going into my garden.

— Gladstone

— Gladstone
For at least 48 hours after, I feel like I have a sinus infection or flu-like symptoms. You’re kind of achy everywhere, and your head hurts. You may even run a temperature. I use cooling strips from the dollar store that go on your forehead. They’re a lifesaver.

— Krivohlavek

— Krivohlavek
Your immunity is down, so I try to stay away from other people. For two to three days after the infusion, take care of yourself, take it easy, and don’t go places where people could be sick.

— Gladstone

— Gladstone

Know What’s Next on an IV Biologic

The treatment landscape for psoriatic arthritis is growing quickly, giving people with the condition more options than ever. Biologics in particular allow for highly personalized treatment regimens, and according to research, they show promise for improving psoriatic arthritis outcomes and overall quality of life.

“In rheumatology, we’re always taught to participate in shared decision-making,” says Sohn. This means you and your doctor should work together to choose the best treatment for you.

Track how you feel before, during, and after each infusion, and keep your healthcare provider in the loop about the symptoms you’re having and your treatment goals. This can help ensure that the IV biologic you’re receiving is the best fit and changes can be made as needed.

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Samir Dalvi, MD

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Samir Dalvi, MD, is a board-certified rheumatologist. He has over 14 years of experience in caring for patients with rheumatologic diseases, including osteoarthritis, rheumatoid ar...

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Susan Jara

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Susan Jara is a health communications strategist and writer with more than 15 years of experience transforming complex medical information into clear, accurate, and engaging conten...

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