I’ve been lurking on here and have learned a lot from your posts so thank you to everyone for sharing your stories and giving tips on how to manage PsA.
About Me: I was diagnosed last year at age 52 but believe I was misdiagnosed for over a decade. My family is the poster family for autoimmune diseases – Type 1 diabetes, MS, lupus, Hashimoto Thyroid, Samter’s Triad, asthma, etc. Basically if you don’t have something autoimmune you are an oddball in the family. I was diagnosed with Hashimoto years ago and was under control for that. I had gone to my primary with multiple symptoms that I suspected were autoimmune related but not sure in what way since it didn’t fit with the thyroid. In the doctor’s defense, he did order some blood tests that all came back negative but mostly dismissed my complaints as minor and not worthy of follow-up. Sound familiar, anyone?
I self-referred to a rheumatologist after worsening foot and hand pain that was no longer controlled by NSAIDs. The doctor walked in the room and in 3 seconds said, “You have an autoimmune inflammatory arthritis. I can tell just looking at your hands. You have dactylitis.” (The sausage fingers had shown up suddenly 10 years ago and was one of the complaints to my primary, BTW.) Subsequent testing gave me a diagnosis of PsA.
I was started on Methotrexate but failed within two weeks due to intractable migraines. He switched me to Humira which was a miracle! Good improvement after first dose. Almost clear and back to normal after second dose. I could walk like a regular person for the first time in years. Unfortunately, the honeymoon only lasted 3 months. After an injection, I developed Humira “flu” the next day, felt like I had been run over by a truck and my body rejected the Humira after that. All the symptoms came back and 3x as bad as before. I have been on Enbrel now for about 6 months. It is working with slow improvement but not as well as the Humira. The psoriasis is mostly under control but still having fatigue and pain flares especially in hands and feet. I just saw my Rheum and he has offered to switch my med again and is letting me choose. Yikes! Trying to research my options but my head is spinning - TNF, IL17, PDE4. Plus I’m worried about burning through all my options. So my questions are:
- Should I switch or stay on Enbrel since it is “kind of” working and I don’t have any side effects other than a little injection site reaction which is improving.
- If I do stay on the Enbrel, should I ask my doctor to add low dose Prednisone. This was recommended by another family member with a different autoimmune diagnosis who feels it has saved his life.
- If I switch, which medication should I try next?
Sorry for the long wordy post. Any and all input it greatly appreciated!