Which biological to try first?

Diagnosed 18 months ago with RA/PsA, tried Plaquenil, Leflunomide, now on Sulfasalazine with methotrexate. Diagnosis confirmed as PsA, right knee damaged resulting in low mobility, talk of knee replacement. Left hip and heel painful plus lower back. Suspect biological will be raised at next appointment with rheumatologist. Which has worked best for others?


Community Answers
  • Lirael author
    5 months ago

    Hi Vicki, thanks for the article with the good summaries. I saw my rheumatologist recently and he has increased the methotrexate to 25mg per week so I now take 15mg on Monday and the additional 10mg on Thursday. He’ll see me in 3 months to see if that makes the difference and because I need to be taking a minimum of 20mg/week for 3 months to then have access to a range of biologics under the government funded Pharmaceutical Benefits Scheme (in Australia). Cost will then not be a factor in treatment choice.

  • VickiN moderator
    7 months ago

    Hi @Lirael! I thought you might find this article helpful:
    https://psoriatic-arthritis.com/living/choosing-biologic-fit-lifestyle/
    The first biologic recommended might be based on your insurance (called step therapy), but I’ll be interested to hear what your Rheumy says. Keep us posted!
    -Victoria, Community Moderator

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