MTX senseless with PsA

[Fred]

I did think of agreeing with you for a change. But your comment about the Bio's made me disagree, as you knew it would.

The doctor who prescribes MTX in PsA, does something what many of his colleagues do too. He is even encouraged to do so by the guidelines, while the effectiveness of this treatment has not been conclusively proven. Nevertheless the NICE guidelines advise to try MTX before considering - well proven effective in PsA - TNF-alpha inhibitors.

Simple answer to that one is Cost. NICE will say this as the NHS is underfunded and not run properly.

They recommended to practitionars that patients should be used with effective conventional means as leflunomide and biologicals.

It's fine saying that but again it's Costs.

Additonal remarks from me... Biologicals can be very dangerous as part of the immune system is inhibited.

I think your choice of Very Dangerous is a bit over the top for the English language. Yes it does weaken the immune system, but I wouldn't consider the Bio treatments to be very dangerous

Name Type dose price/year
Remicade infliximab 5 mg/kg 1 x per 2 months € 19.352.-
Humira adalimumab 1 x per week 40 mg € 32.480.-
Enbrel etanercept 2 x per week 50 mg € 28.260.-
Psorinovo DMF 6 x day 120 mg € 1.200,-

And what about countries where DMFs are not an option under their health system?