Advice needed about DMARDs

[jiml]

Very interesting, Caroline. My DMF is working as well as it ever has, but there is no way I could be where I am with an inflexible treatment orthodoxy. I am sure that your dosing regime is far from experimental and like you I dont see the big deal in maxing the dosage for someone with good blood counts.

What reasons are you being given for the impasse, Jim?

Simple reason Bill is because my rheumatologist says there is no good written evidence that Fumaderm is effective as a treatment for PsA..I have argued that it's used in Germany for treatment and am told that they haven't published evidence of efficacy for PsA...so she  won't prescribe it....

My dermatologist says that the dose of Fumaderm I am on is controlling my psoriasis and won't increase the dose....if I increase it without a prescription I will run out of tablets before my next appointment.
My dermatologist seems unwilling to try me on a higher dose and I'm between the two departments

To my mind it's pathetic, they could say ok here's enough for a higher dose for six months if there's no improvement by then, we will think again....that's all I'm asking of them is a chance to see if it will work on the PsA. And if it doesn't I will back down and follow their instructions...