MTX senseless with PsA

[Caroline]

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.

Indeed, i agree, it is costs.... At the cost of the health of a person.
I for instance, do not want to be that person.
In the longer run the damage to the health and the following extra costly treatments will far outrun the biologicals treatment.

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.

Same answer as before, it is short term shortsighted.

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?

They should be convinced to become a bit more open minded towards this option. There is enough research done. The problem as it appears to me is that they walk between two walls and have no way, nor the willingness to look over this wall. One should not expect this from highly educated scientists.

What now may be happening is that the drive is coming from the farmalogical industries coming with a DMF solution that is 40 times more expensive than it should be.

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