Please give your opinion

I have been on Sulfasalazine and Plaqenil for the last year. I have had to be take 4-5 Norco through out the day to alleviate pain. Mostly upon rising and at bedtime. My rheumy has also been shooting up a couple of joints every 3 months to help with the pain.
Now he is suggesting Humira. I can’t take Methx due to a fatty liver (whatever that means and the implications I don’t know). But Humira and Enbrel scare the snot out of me. The side effects are in fact deadly. Should I wait until I am in so much pain that I can’t fucntion before taking that huge step into biologicals? Please share your opinions and experiences. Thank you all for your input in advance.

The side effects are in fact NOT deadly and both are far safer than the meds you are taking especially Plaquenil. Under few circumstances should anyone with a fatty liver be taking Norco on a daily basis (nor should anyone for that matter) Is your Rheumy prescribing it?

I'm curious has to how your psoriasis is doing Hydrocodone has pretty good record of actually aggravating psoriasis and doing strange things to your pain response (assuming your pain is coming from inflammation)

I assume when you say deadly you are referring to the "cancer issues" (as the deadly infection thing was put to bed years ago) It is partially true IF you are a teenage boy with chrons disease you are at risk for a particular cancer (but every teen boy with Chrons is susceptible with or without biologic medicines) The rest of the cancers are the same or lower. There are few if any other side effects that are reversible.

If you are getting shot up every few months get with an orthopod. That is NOT something most should be doing. In time the softening of tendons etc will actually cause pain. 3 - 6 injections in a life time are plenty.

Marie, I do know where you are coming from. I remember, just after being diagnosed, the fear of the medications for this disease. Lamb is right about “deadly” side-effects, and for that matter, you can look at the information monographs for the most common drugs and see “deadly” SEs listed.

I think you need to put it all into perspective. Two things here –

The PsA fight is not only about pain. Pain is a sign that really bad things are happening inside your body. You need to fear the PsA disease process, make no mistake about it. It used to be believed that PsA was a mild disease. It can be, but if you happen to have an aggressive presentation, PsA can do enough damage to cripple you, and it can do it faster than you’d guess. Think hip and knee replacements and feet which you won’t ever be able to walk on comfortably. The pain is nasty, yes, but the damage is what you really need to fear.

Risks are all relative. If you worried about the risks of crossing the street or driving to work, you’d stay home. But, because you know that you need to have a life, you get behind the wheel and you go as cautiously as you can.

PsA is a vandal and a thief. It will wreck your body and steal your life if you let it. The most aggressive treatment that my rheumatologist will give me is the way I choose to fight those crimes. In my case, better late than never.


PS In the “Book Reviews” section above is an excellent PsA resource. The Kindle version is a bargain, and if you don’t have a Kindle, you can download free software that will allow you to read it on your i-machine or your PC. Knowledge gives you power over this disease and will help you make good treatment decisions with your doctors.

The biologics are safer than the DMARD's. They are just a ton more expensive, which is why we don't get put on them right away. I've been taking one or another of the biologics for 12 years, and I'm not dead, I don't have cancer, and I don't have side effects. I know it's scary. But so is leaving your disease untreated. I lived with PsA for 20 years prior to biologics, and I'll take the biologics any day over the other treatments.