Well, I went to my 1st apt and have finally been dx with PSA. So fortunately, that part was pretty easy. He did have my records from the dermatologist who referred me and had one question. When my derm had me on methotrexate, did it work for me. I responded that it was wonderful in that it cleared my P and took care of most the pain. He then asked why I stopped using it. I said the derm took me off because my liver #'s were too high and he wanted to put me on Enbrel. Heck, he even said I'd need a liver transplant if I stayed on methotrexate. The Rheumy just starred at me and then showed me the lab results my Derm was looking at. He then said the numbers are normal, so I'm not sure what your Derm was looking at....... Obviously I'm not too happy with my derm. Perhaps he was looking to make an Enbrel sale. So at the end of the apt my Rheumy says he would rather me stick to the Methotrexate for now. He says if it works, I should stay on it as long as possible. I am happy with my new Dr. :) Anyone else have Dr's pushing biologics.......
Interesting question. . . Anyone else have drs pushing biologics? Maybe I'm naive, but do they really get any gains from pushing biologics?
I'm more curious as to why the derm claimed that your liver numbers were too high on MTX.
As a side note, I was diagnosed 6 years ago now, and am still not on a biologic. I'm on plaquenil and leflunomide, as well as NSAIDs when necessary, which is more often than not. I'm taking a break from them right now, but it's not going all that well. I've decided to bring up this question with my rheumy, to tell you the truth. Why am I not on a biologic at this point? My hands, which were the first affected part, are warping, and I've been experiencing more and more issues with the big joints.
Docs don't get commision on drugs.
FWIW dermos are very conservative on drugs. I don't know how long you were on the MTX, but if he saw an increase in liver levels two series in a row, It could be too high in his book. MTX is a drug dermies HATE to prescribe. Remember Dermies believe we should sleep during the day to insure we never see the sun. To prescribe a drug that makes exposure to the sun worse just gravels them.
For a rheumie the ONLY tool in their box is drugs. Except for narcos which most won't touch, they have never met on they don't like.