Which treatment to try - biologic or non biologic?

It is advised that patients not drink alcohol while on methotrexate, as your liver already has to work hard enough with methotrexate alone. That said, you can ask your doctor if an occasional glass of wine would be ok. Everything in moderation, right? As for going on a biologic, your insurance will probably dictate if this is an option. Most times patients need to fail a less expensive therapy before insurance gives the thumbs up to try a biologic, which is much more expensive. Even then, your doctor might want you to be on methotrexate and a biologic at the same time. Biologics often work better when combined with methotrexate. I know! It's messy getting a good treatment for psoriatic arthritis. As to whether or not to even try a biologic, you need to weigh the side effects versus the benefits. It's a personal decision, but I can say that my son and I have been on many, many biologics and have never had a problem with side effects, but we did both get pretty sick (vomiting, mood swings, fatigue) while on methotrexate. For me, biologics were the way to go. I got my life back! I've been on the same biologic for 2 years and can now move furniture up and down stairs, walk marathons and climb sand dunes. I'm definitely not saying this will be your outcome. Every patient is different, and every medication is different. I'm just trying to show that I was, at times, in a wheelchair prior to biologics, and now I lead a pretty normal life. Also, the side effects with biologics are pretty rare. I understand they are scary, but they are very rare. I hope this eases your mind a little. Feel free to reach out to me directly if you'd like to talk more. Sending hope for bright days ahead! - Jaime

Hello 😀 It's true, making decision about medications is very difficult and there are always things to weight out, pros and cons. There are many that argue that methotrexate has been a life-saver, while just as many people have had horrible results with it. Either way, it is usually the first line of defense against the progression of PsA.

However, there are other meds that are not biologics, that are in the same "class" as methotrexate that you may find success with before moving on to a biologic. For example, methotrexate did nothing for me, so my dr put me on a medicine called lefleunomide (Arava) that is not a biologic, that many people have success with. And while I "can" have the occasional glass of wine, I've found that my body is (sadly) very angry at me the next day. But, I have found that clear liquors (like vodka for example) seem to be okay. Boy was it interesting testing each thing- lol 😀 to come to that conclusion.

Either way, no matter what you decide, in my opinion the important thing here is that when it comes to medicine that you feel comfortable talking with your doctor about ALL the concerns and options that you may have. You will more than likely require some sort of medical care for your PsA for your entire life, so if you don't have a solid, open relationship with your doctor you may find it difficult as your disease progresses. I like to think of it kind of like a marriage, you want to find a doctor that will stick around with you in good times and bad. Just my 2 cents I guess.
Please pop back around and let me know how you are doing 😀
-Leanne, Community Moderator