Rhuemy recommends Stelara. She mentioned mutilans

General Support
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So I have been in the gap for… many…, a few…, a long time. My new wonderful Rhuemy showed me that I don’t have PsA in my back, neck, hips, feet, etc. Just osteoarthritis.

But, my index finger showed inflammation of the bone at the tip. The inflammation was very apparent in the X-Ray even with my untrained eyes. She said she is concerned about “re-absorption of the bone”. And she mentioned mutilans. She wants me to start on a biologic, but she said, “the insurance company may make you start with Methotrexate”.

This is quite a change in her recommendation from the last appointment (which was to take an NSAID and some supplements for osteoarthritis). This is quite a change from what any of the several Rhuemys that I have seen have said in the past (i.e., it’s mild).

I’m relieved that action is recommended, and scared, and hopeful, and scared, and… on and on with those mixed feelings.

I believe her recommendation for a “jump” to a biologic means that it’s pretty serious. I am surprised, and relieved, that the rest of my body does not show joint damage bc I hurt so much all over.

And I have a bone spur on my hip? I thought that only happens on your heals? I don’t usually walk on my hips! HA! And my knee caps are in the wrong spot, so I have osteoarthritis forming under them. Lots of information to digest…and a “wait to see” what the insurance company will “okay”.

My response to her was,“I know it’s gotten worse since I saw you last. I will do what you recommend”.

Thank you all, on this site, for letting me share.

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Stelara is a great choice PsA without back related issues. If the back is involved, then Enbrel or Humira is better option.

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Yes, right now I only have it in my fingers according to the x-rays.

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The biologics are typically slow acting with the hands and feet, but from my experience, Stelara works well for hands if you put in the time. MTX may help with hands a bit, but it hasn’t been shown to prevent bone damage. I am assuming the recommendation of the biologic is partly due to the reasons I stated. BTW, how bad is your psoriasis?

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Hi mataribot,
I don’t have much skin psoriasis. Only small spots on my legs that have gone away rather quickly. I think I’ve had scalp psoriasis pretty bad at one time but it cleared up with head n shoulders shampoo. I have yet to have a doc actually see it on my scalp. I’ve had something on my face before, but was told it was eczema, not psoriasis. Why do you ask? The doc asked about ps dx also.

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Easier to get biologics approved through dermatology. Psoriasis is rare on the face, but does happen.

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I know this is an old post now, but…the doctors office called today and said that they approved Stelara. Without me taking Methotrexate. I’m happy and a little apprehensive about it. But mostly happy that it was approved!

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I am so glad for you Cheryl. I am on Stelara and have been happy with it. I have only had the 2 loading doses but I do think I see improvement.

There is a school of thought that just as psoriasis moves in where there is skin injury that PsA will move in where OA is. Stelara may stop that from happening. I hope so.

I am still troubled with flares but I hope with time they will be shorter and milder.

Good luck with it.

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Thanks Michael!

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Wow does Stelara cost A LOT…for my insurance company. I guess “I better not quit my day job”!!!

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Insurance companies typically don’t pay retail prices. And the ones they don’t get significant discount for almost always get denied, unless you failed other biologics and it’s deemed necessary.

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Hi Sybil, I made the appt for Monday to learn how to do the injection. I have a 3.5 hour drive so I am thinking of taking my camper and going to a campground on Sunday. I have been pondering a few things. Like, does this mean my PsA is no longer considered "mild"?

I have been feeling some anxiety but also happiness that I am finally going to get some treatment. I'm also looking at my smoking and drinking habits and trying to quit both. They go hand in hand for me. I was not successful last night. Succumbed to the anxiousness I guess!


sybil said:

Hi Cheryl,

sounds like things have taken an 'interesting' turn. You must have been so shocked by the discussion you had with your rheumy. And yet, as you say, there's good reason to be hopeful. It's so good that she took swift action and that you've now been approved for Stelara.

I expect you've been left pondering a few things since that appointment, but most importantly you are due to start Stelara. I hope it helps you a great deal. I guess you may have started already ..... ? I'm looking forward to your update.

My knee caps are in the wrong place too - 'mal-tracking' where the tendons that hold them in place don't stay in their groove - it's very common I believe. As a result that was the one place I definitely had osteoarthritis before PsA. And I'm sure Michael is right about PsA following OA around as my PsA went straight for my knees. It's called the 'deep Koebner effect'.

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The weather is mild right now and the forecast is the same for next week. I will take an electric heater in case it drops real low at night. I'm just hoping for good weather.

If I feel real crappy from side effects, I can get a hotel. I also have a friend from college who lives close to there.

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How's the weather in Shrewsbury Sybil? Across the pond...

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"Like"!

sybil said:

It's just wonderful, one idyllic day after another. I love it when summer lasts like this rather than just odd days ..... that way it becomes a whole way of life for a while.

Cheryl (CLR) said:

How's the weather in Shrewsbury Sybil? Across the pond...

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Omg, Just did my first Stelara shit! It hardly hurt at all. Yay!! I definitely worried for no reason. Hope they all go so well.

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Okay it should say “shot”! I’m in my phone and it doesn’t have the “edit” button…

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That’s great that you are starting Humara this week!
No X on iPhone. Will have to wait until I get to wifi to use my Kindle to fix that “shot”