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Suggest Remedy For Painful Cuts And Patches When Suffering From Psoriatic Arthritis
Question: I have psoriatic arthritis, with painful cuts and scaley patches on my fingers and palms which cause me to drop things and bleed easily when in doing my job (elementary music teacher) I started Humira injections 6 weeks ago, along with Prednisone. Initial clear up, but Once the prednisone stopped, symptoms returned. How long does it typically take to see improvement on Humira?
Brief Answer:
Psoriatic Arthritis treatment
Detailed Answer:
Good evening
Thank you for writing on health care magic
I have seen the picture attached and gone through your history. Your psoriasis does seem quite advanced. Well, for Humira which you started 6 weeks back, I am supposing you would have taken 3 injections only( 40 mg every other week). For us to know the effectiveness of Humira, we need to give it a time period of 3 months at least. If the lesions dont start to heal or if new lesions crop up or you are not able to taper down steroids, then it is considered as a drug failure. Infliximab is still a better drug than Adalimumab for Psoriatic Arthritis. Since you have started Humira, you can give it a try for 6 more weeks.
Secondly, I have gone through your medical history as well but could not find mention about MEthotrexate. Along with Humira, Methotrexate should be added. It is a very good drug for Psoriatic ARthritis. Also it prevents the Antibody formation with Humira which causes decreased effectiveness of Humira in the long run. IF you have never taken it before, you must consider it starting as soon as possible. It will help you taper off Prednisolone as well.
Thirdly, as for the diet lot of people experience flares with Dairy products. It is not a proven thing, but few of my patients have come back and told the flares they get with dairy products. IF you feel after consuming Milk or cheese, you get increased joint pains you can stop them. As such, we dont recommend dietary restrictions. It varies from patient to patient and if one has a flare after certain foods, then you need to record that for yourself and avoid them.
Hope the information was useful
Do let me know about more queries
REgards
DR Naval
Psoriatic Arthritis treatment
Detailed Answer:
Good evening
Thank you for writing on health care magic
I have seen the picture attached and gone through your history. Your psoriasis does seem quite advanced. Well, for Humira which you started 6 weeks back, I am supposing you would have taken 3 injections only( 40 mg every other week). For us to know the effectiveness of Humira, we need to give it a time period of 3 months at least. If the lesions dont start to heal or if new lesions crop up or you are not able to taper down steroids, then it is considered as a drug failure. Infliximab is still a better drug than Adalimumab for Psoriatic Arthritis. Since you have started Humira, you can give it a try for 6 more weeks.
Secondly, I have gone through your medical history as well but could not find mention about MEthotrexate. Along with Humira, Methotrexate should be added. It is a very good drug for Psoriatic ARthritis. Also it prevents the Antibody formation with Humira which causes decreased effectiveness of Humira in the long run. IF you have never taken it before, you must consider it starting as soon as possible. It will help you taper off Prednisolone as well.
Thirdly, as for the diet lot of people experience flares with Dairy products. It is not a proven thing, but few of my patients have come back and told the flares they get with dairy products. IF you feel after consuming Milk or cheese, you get increased joint pains you can stop them. As such, we dont recommend dietary restrictions. It varies from patient to patient and if one has a flare after certain foods, then you need to record that for yourself and avoid them.
Hope the information was useful
Do let me know about more queries
REgards
DR Naval
Above answer was peer-reviewed by :
Dr. Raju A.T
I'm no longer on Prednisone.
What is your opinion of Cyclosporine? My dermatologist prescribed this to add to the Humira - but in reading about it, I am concerned the side effects would be too much for me to handle with my teaching schedule and not a good trade-off for the length of possible effectiveness. The paperwork says can take up to 4 months to achieve effectiveness and Dr said cannot take it longer than 1 year.
What is your opinion of Cyclosporine? My dermatologist prescribed this to add to the Humira - but in reading about it, I am concerned the side effects would be too much for me to handle with my teaching schedule and not a good trade-off for the length of possible effectiveness. The paperwork says can take up to 4 months to achieve effectiveness and Dr said cannot take it longer than 1 year.
Brief Answer:
Psoriatic Arthritis treatment
Detailed Answer:
Good evening
Well Cyclosporine is a good drug, but you are right in being worried about the side effects as one needs to constantly monitor blood pressure, lipid profile and Kidney function tests, apart from the gum hyperplasia which it can cause. It is not usually the first line drug either. Also there is a bit of concern with the uric acid levels in psoriasis as they are already on the higher side and a cyclosporine can cause a mild raise as well. It is slow acting and the dose needs to be tit-rated up. By the time you reach the full dose it will be almost 2 months and thus effectiveness gets delayed. You can take it for more than a year, but with careful monitoring of side effects as mentioned.
What about Methotrexate? Have you used it before??If yes, Was there any reason for stopping it??
Do let me know about this query. Would be happy to answer your further queries
REgards
Dr Naval
Psoriatic Arthritis treatment
Detailed Answer:
Good evening
Well Cyclosporine is a good drug, but you are right in being worried about the side effects as one needs to constantly monitor blood pressure, lipid profile and Kidney function tests, apart from the gum hyperplasia which it can cause. It is not usually the first line drug either. Also there is a bit of concern with the uric acid levels in psoriasis as they are already on the higher side and a cyclosporine can cause a mild raise as well. It is slow acting and the dose needs to be tit-rated up. By the time you reach the full dose it will be almost 2 months and thus effectiveness gets delayed. You can take it for more than a year, but with careful monitoring of side effects as mentioned.
What about Methotrexate? Have you used it before??If yes, Was there any reason for stopping it??
Do let me know about this query. Would be happy to answer your further queries
REgards
Dr Naval
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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