Just deciding which biologic to give a go. Not at all a fan of MTX in terms of side effects (not the “minor” nausea etc) , even though I am a responder, (all very nice when you are diagnosed at 60+, to know that MTX will likely cause liver fibrosis within 5 years, but be unlikely to be dangerous for 15, - but when you are only 37, the 30 years means guranteed problems ( with only a little improvement, because the MTX improvement is only marginal for me.
So in aus, you can’t get biologics on insurance. You can get them, if you match certain criteria on the equivalent of Medicare or Medicaid. Because the standard protocol with Medicare is that MTX must be concurrently prescribed, I’d be very surprised if locaal rheummmy
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I am curious to know where you read that MtX will cause liver fibrosis within 5 years? and if you can get on a bio and have to take MTX whos going to know if you are taking it or not? Just say you are and remove label and return to another chemist for disposal. Just a ramdom thought.
Hi! I am also in Australia . Have been on Humira now for about 5 months (so far so good!)
I am NOT on Methotrexate and hadn't heard that you couldn't have one without the other. I know the supposedly ideal combo is metho + biologic but still up to specialist + patient to decide
Hi - I take both Enbrel and MTX. In my case I take both by injection. Which one to start is a hard thing to decide - there are pluses and minuses to all of them. The published data varies on effectiveness and side affects for each drug. I chose the Enbrel simply because it was a weekly injection with the best effectiveness on the spinal aspects of PsA - which is my primary issue. I have nearly no skin psoriasis so I didn't care much about that.
The weekly injection was a benefit to me because I don't mind needles at all and that way I minimize the risks if I get an infection since the meds wash out more quickly than the ones given once per month. I use the prefilled syringe, not the auto injector because I find it less painful. For the MTX, I started on pills but they tore up my stomach and intestines, so I went to the sub Q injection and the side affects are very minor even though the dosage is high (25MG per week). At least here in the U.S. at my doc's practice if you have severe PsA - which I do - they will hit you will all 3 (biologic, MTX, and NSAID) if you can tolerate them. So far I have. I get a monthly blood test to monitor my liver and red blood cells counts.
The bit about the liver fibrosis is certainly a risk, but that data actually applies to MTX given at the Chemotherapy dosage not the lower dosges for Rhematic diseases. I will warn you that the MTX can be tough the first 2 weeks. I was really tired. I now take folic acid (1mg per night) and an occasional iron pill if I am anemic and it has been fine. The Enbrel never gave me any side affects except a red mark occasionally from the needle. I stuck some hydrocortisone cream on it and all was well.
I am a scientific person by nature - so I looked at the hard data to make my decisions. Find a doc you trust and really ask some hard questions. That is my advice to help you choose.