Another nail in the coffin for the use of MTX for PsA

[Caroline]

Cool, you beat me to the punch. The site I found was a direct link to a pdf. I would never post that type of link.

I don't think rheumatology is slow here in the USA. It's all about the Benjamins. Insurance companies require three traditional DMARDs for at least three months before trying a biologic. There really isn't any thing to try that will work besides steriods. Some doctors get rather upset because some of there severe patients do not have access to good health insurance and have limited access to biologics. I have been yelled at several times about complaining about Stelara and my PsA. If it's not working for my PsA I have every right to seek different treatment.

Indeed I know that they, the insurance companies, first require at least three traditional DMARDs. But in the mean time more and more proof is coming out of the direction of a.o. rheumatology research, which suffers under the same rules, that this is not a smart way to go. First DMARDs appears to make the disease much worse thus causing higher cost for the insurer at a later stage, as then biologicals may work less well on the worsened disease.
With rheumatology it appears that a quick boost with a good working biochemical often reduces the seriousness of the disease, thus lowering the costs in a later stage, even sometimes leading to no treatment at all later on.
As both diseases are auto-immune diseases it is not illogical that this approach will also work with psoriasis.

Conclusion: rather stupid and in no-ones favor. Probably decided behind a desk in a little dark room....