No problem @Frances. Remember ‘Keobner’s syndrome’ is when psorasis starts at the site of the injury to the skin. ‘Reverse Keobner’s syndrome’ is when the psoriasis flees from the site of the injury to the skin.
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I find it very frustrating to be told by a trusted Rheumatologist that Methotrexate is the first line of defence to help stop the progressive damage of PsA and then…here comes another study that sheds doubt on it all. Really, what is one to do while trying to be proactive to remain active when the “science” keeps changing. It means that many could live with regret down the road because they should have done something different. I am becoming very pessimistic about any article that begins with, “Studies have shown…”. Not meant to be a rant.
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Amos, ranting is a well known symptom of PsA. (Well it is in my house).
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I would be weary of putting to much stock in one study or rash understandings that may not capture the issue. Disease is complicated and incorporating data into ones knowledge or understanding can go awry. First, is that in fact what the study says? Second, is one study conducted properly. Third, am I representing the facts or data to say more than it says or not enough… Fourth, how does this knowledge fit into a way that deals with my specific problem or problems. Fifth, is it peer reviewed with concensus. I can say with good confidence that my doctor presented me with this drug and it is commonly used as a treatment. It is a standard here as far as I understand it. The nature of science, (a descriptive state of affairs of a point in time) is such that it can change that is what makes it great. Yes, it is frustrating.
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And ranting is well known in my house too @Amos. When I was at your stage gosh did I rant as many members on here will tell you. The science is frustrating but it’s frankly amazingly progressive too. There is also life beyond mxt too.
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I encourage everyone to read more than the “title” of the study (or first few sentences anyway) or the original post in this thread NOWHERE does it say MTX is NOT effective, only that the biologic they compared to is MORE effective.
Lets be realistic. MTX costs $40.00USD a month where a biologic costs $4000.00 - $15000.00USD/month. The biologic by damn should be better. MTX has fewer serious long term side effects than a biologic. MTX depending on the course of your disease effects some symptoms that a biologic does not. (peripheral vs axial) MTX extends the life of some biologics.
To be blunt - there is a reason physicians with 16 or more years of training prescribe medicine and its not a DIY project based on which study one reads this week. Incidentally the study in question is one piss poor study and doesn’t even meet the minimum statistical requirements. What it is, is step one in the scientific method. “We have reason to believe…” The next steps are not to prove the hypothesis (reason to believe) but rather to disprove the statement. THOSE are the real studies. So far this hypothesis has gone exactly no where and MTX is a very valuable tool (one of many) The tools use for you will be different than the tools used for someone else. we ARE individuals with very specific needs. PLEASE never make the mistake of comparing yourself to others.
Oh and one last thing the study was commisioned and paid for by Manufacturers of Biologic Medications and several of the researchers own stock in the drug companies:
“Dr. Mease has received consulting fees, speaking fees, and/or honoraria from Bristol‐Myers Squibb, Celgene, Galapagos, Genentech, Sun, and UCB (less than $10,000 each) and from AbbVie, Amgen, Janssen, Eli Lilly, Novartis, and Pfizer (more than $10,000 each). Dr. Gladman has received consulting fees from AbbVie, Amgen, Bristol‐Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, Novartis, Pfizer, and UCB (less than $10,000 each) and research support from those companies. Drs. Collier, Liu, Kricorian, and Chung own stock or stock options in Amgen Inc. Dr. Ritchlin has received consulting fees from Amgen, UCB, and Eli Lilly (less than $10,000 each) and from AbbVie, Novartis, Janssen, and Pfizer (more than $10,000 each). Dr. Helliwell has received consulting fees and honoraria from AbbVie, Amgen, Pfizer, UCB, Celgene, and Galapagos (less than $10,000 each) and research support from Novartis, AbbVie, and Janssen.”
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Thank you, always enlightening to hear from you. Now I can’t wait for Sundays so I can take my next dose of MTX! Do you feel that the length of time that it “typically” takes for MTX to work on a newbie like me is around 3-4 months? That’s all I take other than an occasional few days of Celebrex when things get bad. Do things continue to improve after the 4 month mark on 20 mg MTX? Thanks again.
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