I got a new rheumy after 2 years of using a teledoc. There were no rheumatologists who actually saw patients and accepted my insurance for that period of time. I finally got to see a new doctor and he gave me a short physical exam, didn’t check all my joints. He ordered blood work but said there was no rush. I have been on 150 mg shot of Cosentyx for for about 2 1/2 years. I still had psoriasis and a lot of joint pain, swelling and stiffness. So he decided to double it to the 300 mg dose. I made it 2 months before getting concurrent eye and tooth infections. The eye infection went away but I’ve had a tooth infection for about 6 weeks. I’m on my second dose of amoxicillin and a waiting a root canal at the end of January. I can’t start the skyrizi until the tooth infection is completely gone. I’m afraid that won’t be until after the root canal. I’ve been off the cosentyx for about 6 weeks now. I am having a lot of swelling and inflammation. While I was on the double dose, my blood sugar went over 275 and my A1C was 9.7, up from just 6, and my bilirubin and total bilirubin were up and my alt and ast were quite high so I had to stop it. But it’s these infections that are killing me now because I want to start the skyrizi and end the inflammation and pain. My chiropractor has not been able to work on me for a while because of the inflammation and swelling. He doesn’t want to make it worse. I just started seeing him a couple visits ago. I was cervical spinal stenosis and a whole lot more going on. So with the inflammation is swelling I am in a lot of pain and can’t really do much. And not to mention I am more fatigued than i have ever been. Vomiting and diarrhea on a regular basis and I’m pretty sure it’s because of the antibiotics. Constant headache and fire in joints.
Sorry to go on and on but this is all happening and more and you are the only ones who understand.
After saying all that I actually do hope you are doing well. I haven’t been here in a while.
It’s not going to sound like that having to hang about having to wait to start your new biologic is a good thing, but it is. It really is. Cosentyx lasts in the system between 110 and 155 days. And you don’t want two biologics in your system at the same time - believe me. I’ve heard too many issues with people not waiting long enough for Cosentyx to leave the body and starting a new biologic too soon and then having problems. You don’t want those problems on top of how you’re feeling now, I can tell you. And I would definitely wait to start the new one until after the root canal issues too.
So it’s a positive you have to wait. Obviously it’s not a positive you have teeth issues either. Did you know PsA can and does affect teeth too? I very much doubt Cosentyx caused the tooth infection either, PsA likes to do that on its own sadly. It was my first symptom so well before I had any PsA meds.
I do hope you can get off the antibiotics soon.
No, I didn’t know that PSA caused teeth problems. I’ve never had a tooth infection in my life nor an eye infection. However, I’ve noticed over the past few years my teeth are getting weaker and more prone to cavities. And my gums too. I’m assuming this has to do with the constant inflammation then? I’ve been suffering from PsA for about 8 years now and I’ve never gotten rid of the inflammation no matter what biologic or other drug I am taking. I was on prednisone for 3 years and still I had swelling and pain constantly. So I guess I just have a tough case or something. But this is medicine number 10 and biologic number five. They say SkyriZi takes three to six months to start working and this reminds me of the first 3 years with PsA switching medicines going through all sorts of hell basically for years. Another thing that scares me is the pharmacist I was talking to about. It said it is sort of like a big brother version of humira. I took humara for 6 months and it had no effect on my symptoms at all and the shots hurt a lot. So I’m a little bit hesitant about how this is going to work but I am willing to give it a shot because it is new and hopefully works well.
I get an understand what you’re saying about not wanting to start the next biologic until the cosentyx is out of me. That would do a double whammy on my immune system and I would probably die of a cold. Maybe not but I get what you’re saying. Thanks for the input. 
It’s not the whammy effective on your immune system really that causes issues as we only take these sorts of meds because our immune system is already deranged, insane and completely mad. So we have grossly abnormally working immune systems to start with - that’s the reason we have PsA. So we never start off with normally functioning immune systems in the first place.
So we need PsA meds to make our immune systems work normally. You just don’t need two biologics in your system at the same time fighting eachother. Not sure which bit of the T-cell Skyrizi affects but I’m guessing it’s pretty targeted like Cosentyx is. But if it’s like Humira, it’s slightly less targeted than Cosentyx.
Anyway the upshot is Cosentyx is one of the longer lasting in our system biologics and does need to have gone before starting another. Here’s to Skyrizi being your med.
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I can’t really help with the other stuff but I might be able to with the worry that skyrizi won’t help bc humira didn’t -humira is a TNF blocker and skyrizi targets interleukin 23, so they both work on different inflammation pathways. If the TNF blockers (humira, enbrel, remicade, simponi, cimzia) don’t help you much the I23 may work better 
.
But even then if it was a TNF blocker it might work better. I failed humira, enbrel, remicade (antibodies!), and simponi but my second attempt at cimzia is working wonders (I did cimzia years ago but not for very long so we decided to retry before going to my last two options). Bodies are weird and bodies with autoimmune issues are even weirder.
I hope you start feeling better soon - especially that tooth infection. You may see your other symptoms improve once that’s gone since it won’t be activating you immune system any more.
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