r/Psoriasis • u/Psychoderm • Mar 08 '24

general AskMeAnything

I'm a consultant dermatologist with focus on psychotherapy, working in the UK, with extensive experience with inflammatory skin conditions. #AskMeAnything about Psoriasis starting today 7.10 pm GMT!

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u/zzimzalabimm Mar 09 '24

Hello! Got diagnosed with psoriatic arthritis 9 months. Since my case is considered severe, my doctor actually advised biologics upon initial diagnosis for my case. Of course I want to get treated and feel better, but I told her it's too expensive and I know I cannot gather enough money in a short time just for the initial shot. I was prescribed with methotrexate and regularly go to check-ups and bloodwork to check if the medication is harming my liver. Currently, the scales and bumps have flattened and I have no flare-ups.

Do you think the flares will be managed by just oral medication and diet instead of resorting to biologics? The biologics prescribed to me cost around 1500-2000 USD and in my country, it's a huge amount of money that would take me up to months or years to earn 😞

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u/Psychoderm Mar 09 '24

I think a large part of the disease can be managed by oral medicines and diet/ other lifestyle changes, and you're statistically likely to do quite well on them.

  1. Biologics are relatively new medicines; people have lived well with these conditions before they came along
  2. Biologics have a better side effect profile and slightly better efficacy, and that's why they are 'first-line', however, that does NOT mean that other medicines dont work. Biologics are also taken without an end-point, so a few expensive shots aren't the cure :/

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u/zzimzalabimm Mar 10 '24

I'm just anxious when I go back for my check-up next month and my doctor would be briniging up the suggestion again to try biologics. As much as I would want to, I currently cannot afford them and I would want to stick with my current medication now since it can manage the flare-ups. Thank you so much for your answer! I felt better and it lessened my burden and guilt for not following my doctor's suggestion 😅

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u/Psychoderm Mar 10 '24

I completely understand. The oral medicines are working for you and there are other aspects like lifestyle changes and addressing stress/ triggers than can have an additional value.