I've had Psoriasis for 7 years and I was just diagnosed with PSA
So I was just diagnosed with PSA and I'm still trying to wrap my head around it.
I've been on Tremfya for nearly five years and I'm completely symptom free from Psoriasis. In February, I started experiencing tenderness in the proximal joint of the middle finger on my left hand. There's no swelling. I chalked it up to cold weather.
When May rolled around I was still experiencing pain and tenderness, I went to Orthopedic Urgent care thinking it was an injury due to trauma. They diagnosed it as trigger finger and sent me on my way with steroids.
The steroids helped with the pain and tenderness almost immediately but as soon as the treatment stopped, the pain and tenderness returned.
On to the Rheumatologist. After an office visit and exam, he diagnosed it as Psoriatic arthritis. He basically said there were two options: switch from Tremfya to try another biologic or add Methotrexate to my current Tremfya treatment.
As a relatively healthy and active 38 year old father and husband, I feel like a bomb's been dropped in my lap. My mind automatically went worse case scenario and it terrifies me, but I'm working on the mental side.
It was a big enough "pill to swallow" with coming to terms with using a biologic like Tremfya. I really don't know how I feel about starting Methotrexate. It's a powerful drug and once you start any pharmaceutical it's hard to come off it. But I'm also concerned that if I don't do something now, the condition will worsen.
Anyone out there on the combination treatment of Tremfya and Methotrexate that can share their experiences?
Can anyone share their experience with Methotrexate in general?
Combining MTX with any biologic is thought to increase a biologic's efficacy somewhat, but mostly it's RX'd concomitant with a biologic to help stave off immunogenicity, when your body produces antibodies to the biologic drug (ADA's). I would go ahead and try the MTX with the Tremfya, and see where things go. You'll need to take a folic acid supplement, and you can expect to feel some nausea when you first start taking MTX. Your doctors will have you doing regularly scheduled labs, which they're probably already doing, so don't get too concerned about major adverse events. Tremfya is an IL-23 inhibitor, so you're already on what is deemed a very effective biologic. But, be open to the idea of switching to another biologic in the future,
Hi
first let me say welcome to our community. I can relate to the bomb feeling of being first diagnosed. I went through the same thing. Most, if not all, of us have and yes, your brain automatically goes to the worst-case scenario. I thought my life was over. It has been anything but over. Secondly, you really might want to consider trying the methotrexate because once Psoriatic Arthritis does any damage it cannot be reversed. If you do not tolerate it well, you definitely can come off of it. I did with no bad effects. Like with psoriasis it is a life long journey you will know have to deal with but the trick is finding something that works for you. Also I wanted to let you know if you feel like you need some support dealing with the PsA The National Psoriasis Foundation has a program called One to One that will pair you with someone who also has psoriatic arthritis. You can find out more information here: www.psoriasis.org. Hope this helps you. Vickie W., Team Member
