Need PsA and Ps help

[Kat]

Have dermatologists prescribed it for skin psoriasis?  Does research show that it works for the skin and not psoriatic arthritis?  I ask because I'm curious.  Personally from what I've read here, I think there are better options.... but that's just my opinion. 

Yes mickyfinn007 was prescribed it for psoriasis and as far as I know is still using it.

This survey looked at the use of Methotrexate for the treatment of psoriasis from 62 countries: Methotrexate use in psoriasis not uniform

I worded that a bit poorly as I know it's prescribed for skin psoriasis. I think I meant let's not just attack Rheumatologist then if it's about Methotrexate. A lot of meds are not exactly good for us (hence all the warnings on the labels!) I mean even biologics can lower immune response. And no, I am definitely NOT pro Methotrexate, from what I've learned here it would be a last resort for me to try! Honestly I took Acitretin which helped me and I would hesitate to take it again.

I know it's not just about Methotrexate and that some here have had Rheumatologist visits that must have not gone well to feel so strongly. I think for treatment and doctors we have to decide for ourselves and just like I feel anyone who thinks a visit to a rheumatologist is pointless has the right to feel that way, I wanted to stress I feel differently about it.

[Caroline]

Have dermatologists prescribed it for skin psoriasis?  Does research show that it works for the skin and not psoriatic arthritis?  I ask because I'm curious.  Personally from what I've read here, I think there are better options.... but that's just my opinion. 

Yes mickyfinn007 was prescribed it for psoriasis and as far as I know is still using it.

This survey looked at the use of Methotrexate for the treatment of psoriasis from 62 countries: Methotrexate use in psoriasis not uniform

I worded that a bit poorly as I know it's prescribed for skin psoriasis.    I think I meant let's not just attack Rheumatologist then if it's about Methotrexate.  A lot of meds are not exactly good for us (hence all the warnings on the labels!) I mean even biologics can lower immune response.  And no, I am definitely NOT pro Methotrexate, from what I've learned here it would be a last resort for me to try!  Honestly I took Acitretin which helped me and I would hesitate to take it again. 

I know it's not just about Methotrexate and that some here have had Rheumatologist visits that must have not gone well to feel so strongly.  I think for treatment and doctors we have to decide for ourselves and just like I feel anyone who thinks a visit to a rheumatologist is pointless has the right to feel that way, I wanted to stress I feel differently about it. 

The point is that virtually all rheumatologists all over the world start with prescribing methotrexate for Psoriatic Arthritis, where there are serious doubts if they should do that. But the protocol is so carved in stone that there are hardly rheumatologists that do step out of that routine.

Sure after a while most of the psa patients will leave mtx because of a variety of reasons, they can’t cope with it, they have bad liver values, it just doesnt work, and then they go on to something else.
There are very few psa patients that stick with it.

On the opposite there are Psoriasis patients who do well for long times on it, as it does work for Psoriasis.

[Kat]

Have dermatologists prescribed it for skin psoriasis?  Does research show that it works for the skin and not psoriatic arthritis?  I ask because I'm curious.  Personally from what I've read here, I think there are better options.... but that's just my opinion. 

Yes mickyfinn007 was prescribed it for psoriasis and as far as I know is still using it.

This survey looked at the use of Methotrexate for the treatment of psoriasis from 62 countries: Methotrexate use in psoriasis not uniform

I worded that a bit poorly as I know it's prescribed for skin psoriasis.    I think I meant let's not just attack Rheumatologist then if it's about Methotrexate.  A lot of meds are not exactly good for us (hence all the warnings on the labels!) I mean even biologics can lower immune response.  And no, I am definitely NOT pro Methotrexate, from what I've learned here it would be a last resort for me to try!  Honestly I took Acitretin which helped me and I would hesitate to take it again. 

I know it's not just about Methotrexate and that some here have had Rheumatologist visits that must have not gone well to feel so strongly.  I think for treatment and doctors we have to decide for ourselves and just like I feel anyone who thinks a visit to a rheumatologist is pointless has the right to feel that way, I wanted to stress I feel differently about it. 

The point is that virtually all rheumatologists all over the world start with prescribing methotrexate for Psoriatic Arthritis, where there are serious doubts if they should do that. But the protocol is so carved in stone that there are hardly rheumatologists that do step out of that routine.

Sure after a while most of the psa patients will leave mtx because of a variety of reasons, they can’t  cope with it, they have bad liver values, it just doesnt work, and then they go on to something else.
There are very few psa patients that stick with it.

On the opposite there are Psoriasis patients who do well for long times on it, as it does work for Psoriasis.

How can you know that "virtually all rheumatologists all over the world start with prescribing methotrexate for Psoriatic Arthritis"? I'm not saying they do or they don't but want to know where you got that information.

[Caroline]

Have dermatologists prescribed it for skin psoriasis?  Does research show that it works for the skin and not psoriatic arthritis?  I ask because I'm curious.  Personally from what I've read here, I think there are better options.... but that's just my opinion. 

Yes mickyfinn007 was prescribed it for psoriasis and as far as I know is still using it.

This survey looked at the use of Methotrexate for the treatment of psoriasis from 62 countries: Methotrexate use in psoriasis not uniform

I worded that a bit poorly as I know it's prescribed for skin psoriasis.    I think I meant let's not just attack Rheumatologist then if it's about Methotrexate.  A lot of meds are not exactly good for us (hence all the warnings on the labels!) I mean even biologics can lower immune response.  And no, I am definitely NOT pro Methotrexate, from what I've learned here it would be a last resort for me to try!  Honestly I took Acitretin which helped me and I would hesitate to take it again. 

I know it's not just about Methotrexate and that some here have had Rheumatologist visits that must have not gone well to feel so strongly.  I think for treatment and doctors we have to decide for ourselves and just like I feel anyone who thinks a visit to a rheumatologist is pointless has the right to feel that way, I wanted to stress I feel differently about it. 

The point is that virtually all rheumatologists all over the world start with prescribing methotrexate for Psoriatic Arthritis, where there are serious doubts if they should do that. But the protocol is so carved in stone that there are hardly rheumatologists that do step out of that routine.

Sure after a while most of the psa patients will leave mtx because of a variety of reasons, they can’t  cope with it, they have bad liver values, it just doesnt work, and then they go on to something else.
There are very few psa patients that stick with it.

On the opposite there are Psoriasis patients who do well for long times on it, as it does work for Psoriasis.

How can you know that "virtually all rheumatologists all over the world start with prescribing methotrexate for Psoriatic Arthritis"?  I'm not saying they do or they don't but want to know where you got that information.

Well I know it from a Dutch forum for the Dutch situation, and it is in the medical “guidelines”.
And in this forum, which is quite international, it has been happening a number of times.

[KatT]

FYI - first medication I was prescribed was MTX and it was by a dermatologist.

That being said, I have not experienced side effects.

[jiml]

I was prescribed it for psoriasis by a dermatologist and it worked for me but I couldn't hack the side effects that bothered me more than psoriasis as psoriasis won't kill you but can make life uncomfortable and painful

[Kat]

It seems like most of the people here who were prescribed it were by a dermatologist.  I do think it was the go to for years but perhaps with more treatments it's not as much as it used to be?

My Rheumatologist DID say that insurance might require it before biologics due to the cost, but he didn't prescribe it nor did the insurance suggest it.  My first dermatologist said it probably would be creams (ointments), oral meds and then biologics for skin psoriasis (he said due to cost to patient)  My oral med was Acitretin. 

I do understand that a lot of doctors do prescribe Methotrexate but my experience is that at least one doesn't and I do think there is more than one  .  As for the forum here  being used as reference, once you take out the ones where it was prescribed by a dermatologist, I'm not sure how many Rheumatologist are represented here as it being the first medication they would offer and also how recent since more and more drugs become available for treatment perhaps now it's less than it used to be.

I'm not saying it's not still over prescribed for psoriatic arthritis by rheumatologists, I can only speak from my personal experience.  But it's an interesting conversation.

I'd still go for it with a rheumatologist though for another opinion. 

[Caroline]

I'd still go for it with a rheumatologist though for another opinion. 

Oh… I won’t deny that, I would do the same.
But I will keep my personal experiences, which are 100% negative on this part with several rheums, with me and be very critical.

I even once had a discussion with a rheumatologist, together with my internist, explaining the how and why of the way of thinking and background of my internist, so also from solid medical point of view. He listened, mumbled a bit, and still has done nothing with it.

[Kat]

I'd still go for it with a rheumatologist though for another opinion. 

Oh… I won’t deny that, I would do the same.
But I will keep my personal experiences, which are 100% negative on this part with several rheums, with me and be very critical.

I even once had a discussion with a rheumatologist, together with my internist, explaining the how and why of the way of thinking and background of my internist, so also from solid medical point of view. He listened, mumbled a bit, and still has done nothing with it.

And it's those varied experiences that make this board informative and interesting. I like that we can disagree but not argue.

[Functionalfool]

My dermatologist put me on Taltz. Does anyone have experience with that drug? 

I saw a rheumatologist but he wanted me to go on a paleo diet and that ain't gonna happen! I'm not going to cut out gluten and alcohol unless there is significant proof that it will help and that info does not exist. That diet is high in nuts and fruit and many ppl on here have warned me to be careful with fruit skins and peanut products. I'm going to stick with my dermatologist for now. 

I am def going to try and eat better, but only thing I'm going to cut out is high fructose corn syrup and I'll still drink a Pepsi periodically. I'm going to just try and eat healthier, no more and no less. Instead of spaghetti Os, I'll make homemade spaghetti.

Back to my original question, if anyone has any info about Taltz please post or pm me! It'll take a week or 2 for insurance to approve it because it's over $100,000 a year, and then a few days to get it delivered so I have time to stop the process if I get a million responses telling me to avoid it. 

This site has been very helpful, thank you guys so much!!