Advice needed about DMARDs

[Fred]

Thanks Fred and all for suggestions  they have all helped me in my discussion  

Well yesterday afternoon I went to my  appointment with the Rheumatology nursing practitioner who to be honest spent more time than I deserved with me. She has been in rheumatology for years and is passionate about treatments and we spent a long time discussing the various treatments, she has ruled out biologicals as I have to try salfasulfazine or leflunomide or methotrexate before being considered for biologicals. I learnt a lot from her and have a lot of respect for her and the amount she knew

I explained my position that I had a good drug that works excellently on my psoriasis and that I am reluctant to give it up for fear of my psoriasis returning. I said I was quite prepared to try something but that I was keen to see if Fumaderm at a higher dose could work for me.

I had been to the dermatologist earlier in the week and he wrote to rheumatology saying if they agreed he would up my dose ......as my bloods were good lymphocytes were 1.35 and all other functions were good

She has agreed to go with my suggestion and for me to go and see her again in 3 months and we can assess the arthritis again and if there is no sign of improvement or the scans show further erosion of the joints, I feel I will have no option other than to try leflunomide as she was keen to halt the deterioration

I can't speak for the others Jim, but you are welcome. Psoriasis Club is all about sharing and support from real people with no ulterior motive, we're all in it together and if our conversations help each other then Psoriasis Club is doing it's job as I intended it it to do.

If it helps, I would still say stick with Fumaderm. Leave the Bio's alone until you really need them (you won't need to ask when that is with psoriatic arthritis as it will strike you down very hard when the time comes) but for now enjoy your life with mild psoriatic arthritis