Question
I am a 49 year old woman, Dx’d with psoriatic arthritis which had gone undiagnoised and untreated for probably 5 years or more, which is in the spine, Just three months ago began seeing Rhumetalogist who put me on methotrexate, but the sed rate of 52 is not moving–he wants to put me on Humira, which I understand seems to show some significance with treating psoriatic arthritis, however, the cost to me with insurance is more than I can afford. I wonder what alternatives there might be if any, and if no real alternatives I would like to know what the long term prognosis is without treatment.
Answer
Prognosis is very difficult to predict, largely because the disease will vary widely from patient to patient. To complicate matters, the disease course may also vary in the individual patient with flares and remissions, often independent of treatment. However, in general, your course over the past 5 years may be helpful in predicting the future. Particulary in patients with spine involvement, the TNF inhibitors (Humira, Enbrel, Remicade)would be the most effective next step after methotrexate.
