(Thu-03-03-2016, 15:40 PM)Fred Wrote:

(Thu-03-03-2016, 15:37 PM)jiml Wrote: If anyone shoots you down Fred I will give them a good  

Thank you Big Jim.  

I will say though don't be scared of the Bio's. We can all read bad things about all treatments, do your homework and have a plan just in case.  

I will do my homework and thank you for your advice it is always welcome

Lets just be honest. Most people will never see anything more than 20% reduction in symptoms of PsA with current medication (That includes biologics). The only thing to switch to would be a biologic, but the current evidence suggests they are very slow working for hands and feet. My suggestion would be to remain on FD, and if you can try some NSAIDs and see if that helps.

(Thu-03-03-2016, 17:22 PM)mataribot Wrote: Lets just be honest. Most people will never see anything more than 20% reduction in symptoms of PsA with current medication (That includes biologics). The only thing to switch to would be a biologic, but the current evidence suggests they are very slow working for hands and feet. My suggestion would be to remain on FD, and if you can try some NSAIDs and see if that helps.

Thanks Mataribot I'm hoping that's what will happen, at the moment I'm happy as I'm not experiencing a lot of pain, it is mainly first thing in the morning or if I'm inactive for a while
Just being prepared for when it gets worse or better still to head it off so it doesn't get worse

Can you take NSAIDs? Maybe try one in the morning. It helps me. However, not something you want to take long term.

I do want to mention one more thing. It is odd that you complain about pain after inactivity when there is no inflammation.

Yes I could take NSAIDs but I choose not to if the pain gets bad, but I want to have something in reserve
So I won't take anything more than I have to to ease pain, and as I can deal with it adequately at the moment I will hold back, thanks for that thought though

And yes it's when I sit and watch for instance a film on fv, when. I move afterwards, my feet are as painful as they are in the mornings   .. But the pain goes after a few minutes moving around

(Thu-03-03-2016, 14:22 PM)jiml Wrote: Just had a reply after my appointment with the rheumatologist which suggests I have a form of arthritis
The reply is as follows

Quote:The ultrasound scan of your hands has shown no active inflammation , but you had erosions on the X-rays of your feet. This suggests there has been inflammation here, if not now then certainly in the past. I know your preference was to increase your Fumaderm dose before considering other medications . As you are aware Fumaderm isn't something I am familiar with, but I know you are due to see Dr **** again in clinic in a couple of weeks time so you could discuss increasing the dose then. I would point out however that there is no good data for using Fumaderm in psoriatic arthritis, and my preference would be to give you methotrexate.
Please let me know if this is something you would go back on . Otherwise I'll see you again in clinical planned

I haven't replied yet as I will try to gather information on Fumaderm supporting me staying on it before I respond
But there's no way I will go back onto the Methotrexate as I have had that experience and got over it

I look forward to any comments

Well it's easy Jim.
The doctor does not know of any data for using Fumaderm in psoriatic arthritis. But he already admitted that he is not familiar with it, so I guess he is totally incompetent of making such a remark. I mean if you know nothing you know nothing and you cannot claim things that you can't know.

Bill and I are both the living examples of the fact that it helps brilliantly for PSA.

You can also suggest that your derm does a phone call to dr. F. Van Loon in the city of Utrecht. He has treated hundreds of patients with DMF, of which no doubt, lots with PSA. If you want I can search for his phone number.
I think that is a very pragmatic approach.

Don't mind Fred, he is hard to convince   , it's no time yet to immediately jump to stelara if the increase of Fumaderm is so obvious.
If it becomes very much worse there is always still time for doing that.

By the way, I am also a bit stiff in the morning, but that disappears in seconds under the shower.

(Thu-03-03-2016, 17:22 PM)mataribot Wrote: Lets just be honest. Most people will never see anything more than 20% reduction in symptoms of PsA with current medication (That includes biologics). The only thing to switch to would be a biologic, but the current evidence suggests they are very slow working for hands and feet. My suggestion would be to remain on FD, and if you can try some NSAIDs and see if that helps.

Well at least Bill and me do, for at least 90%, but maybe that falls under the exceptions.

Thanks Caroline I know of Bill and your success with the DMF treatment and I'm sure it's what is holding PSA in reasonable check for me
And that phone number would be useful you can pm me please if you have it

Quote:Caroline wrote

By the way, I am also a bit stiff in the morning, but that disappears in seconds under the shower.

and me but it goes after a cold shower

(Thu-03-03-2016, 17:22 PM)mataribot Wrote: Lets just be honest. Most people will never see anything more than 20% reduction in symptoms of PsA with current medication (That includes biologics). The only thing to switch to would be a biologic, but the current evidence suggests they are very slow working for hands and feet. My suggestion would be to remain on FD, and if you can try some NSAIDs and see if that helps.

This is what I like about Psoriasis Club we have a good mix of people giving personal opinions from their own experience. It also goes to prove that we are all different and there is no one suit's all as far as psoriasis and psoriatic arthritis is concerned    

But as much as I don't like agreeing with Caroline, I'm with her and I must be one of the exceptions. I have seen a huge reduction in symptoms and I would say for me personally a 90% reduction. I have gone from not being able to get out of bed, dress myself, and even cut my food up or lift a cup to living an almost normal life for my age. Yes I've had set backs since being on Bio's but nothing anywhere near only 20% reduction.

And sorry to disagree again Matari but I too have had pain without inflammation. So again it just goes to show that like psoriasis psoriatic arthritis can effect us all in different ways.

@Caroline I don't need convincing. Jim was asking for comments, I gave him mine and expected that sort of reaction from you.