1. Community
  2. Skin and nails
  3. Psoriasis and Psoriatic Arthritis

Benefits of DMARDS vs. Biologic for PA?

Posted , 5 users are following.

doug55318
doug55318

Hi,

I've had PA for almost two years and have been treating it with a low dosage (15mg per week)  of Methotrexate. Although it has prevented further joint damage in my left foot, I continue to have seen some deterioration in the right foot with the metatarsal arch collapsing as well as planter fasciitis symptoms. Recently I was advised by my dermatologist that I should consider trying biologics (like enbrel) as he says that they are "game changing" vs Dmards and less toxic. My rheumatologist thinks I'm doing fine (compared to his other patients) but I continue to have difficulty walking any distances, and I'm concerned about further foot damage. Has anyone had similar experiences and can you offer advice on how to proceed with possibly changing medications? Should I get a second opinion from another rheumatologist? Also how much insurance coverage would I expect to receive on this class of drug?

Thanks Doug 

0 likes, 3 replies

3 Replies

  • muddypaws
    muddypaws doug55318

    Posted

    I've Doug, I've was diagnosed with PA 20 years ago after a shambolic diagnosis process. I took sulphasalsine and diclofenac initially as I was unable to take methotrexate due to me trying for a baby. After the birth of my son my condition deteriorated dramatically and I then went on to methotrexate along with diclofenac. Unfortunately,  this didn't prevent my neck and wrist joints from fusing so after much persuasion my rheumatologist finally agreed to put me on enbrel. I can honestly say it's given me my life back.  I've taken enbrel for 11 years now. I can't answer re life insurance but as long as it's declared for travel insurance it's been no issue.  If you are in a lot of pain and your condition is progressing I wouldn't hesitate if it's in offer. Sorry I've rambled a bit. Good luck. 

  • borderriever
    borderriever doug55318

    Posted

    I was diagnosed with PSA over thirty years ago and it was found I could not take any of the DMARDS, this brought about the withdrawal of any Biologics because they would not give these medications if I could not complement them with DMARD medications.

    I now only use all their creams as they seem to cause thinning of the skin. They have now given me some new creams and the seem to control the skin problems I still suffer from.

    I have extensive problems with trapped nerves and damage to tendons and that makes for a difficult retirement.

    If you can manage this cocktail of Biologic and DAMARD, go for it. Both medications bang the immune system down so it will be very important to get bloods done regular to make sure the White Blood Shells are ok

    You could try the charity PAPAA they deal with not only the skin they specialize on joint problems and treatment plans. They also keep us informed when new medications are introduced. So give them a try

    BOB

  • Okapis
    Okapis doug55318

    Posted

    First thoughts on reading your post is that 15mgs is a low dose especially for a man and could be upped if the PsA progression has not been halted by the current dose.

    If you're in the UK, you have to try two traditional DMARDS first and only when they fail can you advance to Biologics. I'm now on my second biologic drug (I was on enbrel for 12 yrs but inflammation started up in my jaw) and would not hesitate to recommend going onto a biologic. I'm in my late 60's so am not too worried about long term effects and value the added pain free mobility the drugs have given me.

    Dont need to worry about alcohol consumption either which is a plus unlike methotrexate.

    Do you mean life or health insurance. If the latter I assume youre in the USA?

Back to top

Report or request deletion

Thanks for your help!

We want the community to be a useful resource for our users but it is important to remember that the community are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the community is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.