May sound like a silly question but what do the different treatments do? I have seen loads and loads mentioned on here. Just want to know to be prepared for rheumy appt in Jan.
I know someone said to me to try and ring nurse but I have no contact details for them so have to wait until Jan to see doc.
Pain and swelling still not good. PS flaring now too for the first time in a couple of years. Nothing like it was about 5 years ago when first diagnosed/treated x
Well … my ‘idiot’s guide’ to PsA meds (the idiot being me):
Steroids: help reduce inflammation & make people feel better - bad news long term, good ‘rescue remedy’ short-term or while waiting for other meds to take effect.
Traditional DMARDs: i.e. ‘disease modifying anti-rheumatic drugs’ e.g. Methotrexate, Sulfasalazine, Leflunomide (Arava) & some others - these may slow progression of joint damage. There is some doubt as to whether they really do this in PsA though. They can reduce swelling, ease up joints and make people feel better. They can also help to ‘prop’ up biologic drugs.
Biologics: the ‘new’ DMARDs. More likely to truly slow progression of disease and thereby protect against disability. Can be excellent at reducing swelling and may help with fatigue. Examples: Humira, Enbrel … plus loads more coming through all the time.
And there are more types! The thing many of us want is to slow disease progression. That may not be uppermost in our minds when we feel like the living dead and just want to FEEL BETTER! But anything that slows the disease right down may well contribute to improvement in a wide range of symptoms.
Oh, I forgot NSAIDs … often useful to handle day-to-day pain.
Phew, exhausted now! Good luck!
Thank you xx
And you forgot pain relief - like co-codomal, tramadol, good old paracetemol too.
Freyza, I see you’re in the UK, so am I.
PAPAA (google it) is a really good place to go to get an understanding of the PsA meds available in the UK and how they’re prescribed and often why. Far easier than wading through the NICE website, that’s for sure.
I also see you’ve been treated previously - that will also have a bearing on what’s chosen in Jan to treat you too. Basic rule of thumb is that two DMARDs like mxt, sulfasalazine and/or leflunomide needs to have failed to work for you, before biologics are considered. And further you must have 3 or more swollen joints according to your PsARC examination before any biologic can be funded by the NHS for you. A PsARC examination is simply a method of recording how each joint in your body feels to the rheumatologist during the physical examination.
Sadly too many rheumys in the UK aren’t PsA specialists either. So I hope the one you’re seeing is such an expert. Best of luck in January. x
Has anyone here stopped taking all arthiritis meds due to liver problems?
Hi Nanabecky,
what sort of liver problems?
I stopped Mtx due to raised ALT but all was well eventually. I’m hoping your problems aren’t too serious, but tell us more.
I’ve been on biologics for four years. My liver enzymes were always normal. I started having upper Right quadrant pain. My Internist sent me for a fibroscan. It came back severe fibrose liver. I have an appt with gastro dr this week. But, in the mean time I discontinued biologics and also statin drugs I was taking. I’ve read that psoriatic Arthiritis and fatty liver may go hand in hand. Four years ago I didn’t have fatty liver disease but, now it appears I could have cirrhosis. I’m terrified. My psoriasis is coming back with a vengeance but, I’m not in too much pain.
Horrible situation to be in. I googled … got the impression that this could turn out okay-ish, I bet you’ve done a fair bit of googling.
Please let us know what the gastro doctor says. I’m so glad that the PsA is okay-ish so far. Obviously I don’t know enough about fibrosis of the liver to comment further but I hope any members who have similar experiences to yours will get back to you.
Hmmmmm, that’s interesting. I have fatty liver but the first time it was noticed the doctor told me i didn’t need to worry. Last month when I had several tests at the ER one of the reports again mentioned I have fatty liver disease. My doctors seem to just overlook these things or make light of them.
My New Years resolution is to try to avoid doctors except for my twice-yearly follow-ups, and not bother to tell them if I do have any new pain or symptoms. It always turns out to be a waste of time and money, and somehow I usually end up figuring out myself how to deal with new things as they pop up.
Very frightening situation to be in. And please do let us know what the gastro guy says.x