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Suggest Treatment For Severe Psoriasis
Question: Dear Sir / Madam
My Name is XXXXXXX I am 33 years. Female. I have two children. My family planning is over. I am having absolutely happy life in all respects with family condition, financial condition and others. I am from Andhra Pradesh.
I have only one health problem is PSORIASIS. I am having this problem from last 15 years. Due to my husband job, we stayed in XXXXXXX for 12 years. I was having serious Plaque Psoriasis on all over body. I tried phototherapy, homeopathy; but didn’t get relief; then I have taken one XXXXXXX doctor (dermatologist) consultancy in GANGARAM hospital for PSORIASIS. He made required tests and asked me to start FOLITRAX tablet 20 mg per week. I used it for 18 months; there was excellent result with this tablet, total psoriasis cleared from my body. Then started using 15 mg for week for six months, then 10 mg per week more than one and half year. So I used Folitrax tablet almost for three and half years. Psoriasis is under control with excellent result, but I had some side effects in this duration like DIARRHEA, SKIN BURNING, and SEVERE HAIR FALLING. I was getting LFT, KFT frequently in this duration; small deviations were there in LFT, but recovered to normal with some other medicines.
Later (after 3 years using of this tablet) I got test for FIBROSCAN test for liver Result is normal. But we are scared with FOLITRAX tablet using after 3.5 years also, as it will damage liver. We stopped using the same from last 6 months as trying with Ayurveda medicine, which is giving little bit result, but not at comfort or satisfactory level.
Now we are requesting advice for better treatment for psoriasis. We can spent any amount for relief, we know that it will not be cured 100%, but we want to know best treatment without affected other health conditions. Recently we came to know Biological injection of SCAPHO for psoriasis;
Long time using of Folitrax is problem?
Please advice us using SCAPHO. Is it good or better than Folitrax?; Is it having any side affects ?
Kindly advice me in this regard.
My Name is XXXXXXX I am 33 years. Female. I have two children. My family planning is over. I am having absolutely happy life in all respects with family condition, financial condition and others. I am from Andhra Pradesh.
I have only one health problem is PSORIASIS. I am having this problem from last 15 years. Due to my husband job, we stayed in XXXXXXX for 12 years. I was having serious Plaque Psoriasis on all over body. I tried phototherapy, homeopathy; but didn’t get relief; then I have taken one XXXXXXX doctor (dermatologist) consultancy in GANGARAM hospital for PSORIASIS. He made required tests and asked me to start FOLITRAX tablet 20 mg per week. I used it for 18 months; there was excellent result with this tablet, total psoriasis cleared from my body. Then started using 15 mg for week for six months, then 10 mg per week more than one and half year. So I used Folitrax tablet almost for three and half years. Psoriasis is under control with excellent result, but I had some side effects in this duration like DIARRHEA, SKIN BURNING, and SEVERE HAIR FALLING. I was getting LFT, KFT frequently in this duration; small deviations were there in LFT, but recovered to normal with some other medicines.
Later (after 3 years using of this tablet) I got test for FIBROSCAN test for liver Result is normal. But we are scared with FOLITRAX tablet using after 3.5 years also, as it will damage liver. We stopped using the same from last 6 months as trying with Ayurveda medicine, which is giving little bit result, but not at comfort or satisfactory level.
Now we are requesting advice for better treatment for psoriasis. We can spent any amount for relief, we know that it will not be cured 100%, but we want to know best treatment without affected other health conditions. Recently we came to know Biological injection of SCAPHO for psoriasis;
Long time using of Folitrax is problem?
Please advice us using SCAPHO. Is it good or better than Folitrax?; Is it having any side affects ?
Kindly advice me in this regard.
Brief Answer:
Secukinumab is a newer biological treatment for psoriasis
Detailed Answer:
hello. thank you for writing to us
I am dr.kakkar(dermatologist).
I have gone through your query and i have noted your concern
Yes, though folitrax (methotrexate) an excellent treatment option for psoriasis can cause liver toxicity on long term use.
Biologicals like adamimumab (humira), Ustekinumab and secukinumab (scapho) are newer and excellent treatment options too which are more likely to result in complete and prolonged remissions of psoriasis. However, since these biologicals act through modification of immune system therefore they can have side effects like increased susceptibility to new infections and reactivation of previous tuberculosis. Nevertheless these newer therapies are preferred by patients and doctors alike apart from being expensive.
Hope this is of assistance
Regards
Secukinumab is a newer biological treatment for psoriasis
Detailed Answer:
hello. thank you for writing to us
I am dr.kakkar(dermatologist).
I have gone through your query and i have noted your concern
Yes, though folitrax (methotrexate) an excellent treatment option for psoriasis can cause liver toxicity on long term use.
Biologicals like adamimumab (humira), Ustekinumab and secukinumab (scapho) are newer and excellent treatment options too which are more likely to result in complete and prolonged remissions of psoriasis. However, since these biologicals act through modification of immune system therefore they can have side effects like increased susceptibility to new infections and reactivation of previous tuberculosis. Nevertheless these newer therapies are preferred by patients and doctors alike apart from being expensive.
Hope this is of assistance
Regards
Above answer was peer-reviewed by :
Dr. Priyanka G Raj
Dear Sir
Thank you for your response.
We understood your input about Folitrax and Scapho.
As per my awareness best options available at present for Psoriasis are Folitrax and Scapho. Am i correct ?
If these two are available
We already used Folitrax (time and quantity) as described below. As on date my LFT/KFT are normal. But i am not aware how much quantity of Folitrax more i can take / absorb without any problem. I have not taken Folitax from last six months with a fear of side effect. Now i have severe Psoriasis, trying with Ayurveda from last six months, but not getting relief.
We can afford expenses of SCAPHO, as we aware this injection cost. We are not worrying about money. But again we are scared about any side affect; because it is new drug and it is biological. you also confirmed that increased susceptibility to new infections. (i don't have any TB) So again that risk will be there.
Are there any other serious side affects with this injection ?
Now we are in dilemma which options is to be selected ?
kindly advice me as per my provided input and situation.
I had already used Folitrax (1 year 20mg per week, 8 months 15mg per week, 6 months 12.5mg per week, 10mg 6 months per week, 5mg 6months per week.)
I can afford any amount for safe treatment to get relief from psoriasis.
I have two children, no more planning for children. My age is 33.
Kindly advice me in detail.
Thank you and regards
Thank you for your response.
We understood your input about Folitrax and Scapho.
As per my awareness best options available at present for Psoriasis are Folitrax and Scapho. Am i correct ?
If these two are available
We already used Folitrax (time and quantity) as described below. As on date my LFT/KFT are normal. But i am not aware how much quantity of Folitrax more i can take / absorb without any problem. I have not taken Folitax from last six months with a fear of side effect. Now i have severe Psoriasis, trying with Ayurveda from last six months, but not getting relief.
We can afford expenses of SCAPHO, as we aware this injection cost. We are not worrying about money. But again we are scared about any side affect; because it is new drug and it is biological. you also confirmed that increased susceptibility to new infections. (i don't have any TB) So again that risk will be there.
Are there any other serious side affects with this injection ?
Now we are in dilemma which options is to be selected ?
kindly advice me as per my provided input and situation.
I had already used Folitrax (1 year 20mg per week, 8 months 15mg per week, 6 months 12.5mg per week, 10mg 6 months per week, 5mg 6months per week.)
I can afford any amount for safe treatment to get relief from psoriasis.
I have two children, no more planning for children. My age is 33.
Kindly advice me in detail.
Thank you and regards
Brief Answer:
Go for biologicals if you can afford it
Detailed Answer:
hi.
Apologies for delayed reply.
Biological therapies are well established forms of treatment for psoriasis. Though there is a risk for side effects but the benefits outweigh risks for patients with severe psoriasis. With folitrax there is an upper limit of 4gm cummulative dose which should not be exceeded without a liver biopsy. So if your cummulative dose of folitrax is less than 4 gms you can still continue with folitrax and thereafter only after a liver biopsy.
The main concern with biologicals is their expense. So, if you can afford it well and good.
Regards
Go for biologicals if you can afford it
Detailed Answer:
hi.
Apologies for delayed reply.
Biological therapies are well established forms of treatment for psoriasis. Though there is a risk for side effects but the benefits outweigh risks for patients with severe psoriasis. With folitrax there is an upper limit of 4gm cummulative dose which should not be exceeded without a liver biopsy. So if your cummulative dose of folitrax is less than 4 gms you can still continue with folitrax and thereafter only after a liver biopsy.
The main concern with biologicals is their expense. So, if you can afford it well and good.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Sir,
FOLITRAX
I got test of FIBROSCAN after usage of quantity as described above which makes around cumulative 2 gm. I am getting LFT / KFT test regularly and those are normal.
Can i take 2gm more safely without going to BIOPSY, if LFT/KFT is being monitored ?
SCAPHO
I know it is expensive. We are ok with that, but we are more concern consequences later taking this injection.
You had also confirmed that increased susceptibility to get new infections with SCAPHO injection due to suppression of immune system.
So, If i am getting other infections very easily, will it be difficult for my balance life ?
Is SCAPHO is having any serious life threat side affects ?
Am i need to take SCAPHO injection life long ?
THIRD OPTION
Is there any better third option than above, if we are ready to afford. In XXXXXXX or anywhere ?
with regards
XXXX
In continuation to my mail.
what is the cumulative quantity limit for SCAPHO Injection ? like 4mg limit to Folitrax.
Are there any live ingredients in SCAPHO injection ?
with regards
FOLITRAX
I got test of FIBROSCAN after usage of quantity as described above which makes around cumulative 2 gm. I am getting LFT / KFT test regularly and those are normal.
Can i take 2gm more safely without going to BIOPSY, if LFT/KFT is being monitored ?
SCAPHO
I know it is expensive. We are ok with that, but we are more concern consequences later taking this injection.
You had also confirmed that increased susceptibility to get new infections with SCAPHO injection due to suppression of immune system.
So, If i am getting other infections very easily, will it be difficult for my balance life ?
Is SCAPHO is having any serious life threat side affects ?
Am i need to take SCAPHO injection life long ?
THIRD OPTION
Is there any better third option than above, if we are ready to afford. In XXXXXXX or anywhere ?
with regards
XXXX
In continuation to my mail.
what is the cumulative quantity limit for SCAPHO Injection ? like 4mg limit to Folitrax.
Are there any live ingredients in SCAPHO injection ?
with regards
Brief Answer:
Biologicals are better
Detailed Answer:
hi
biologicals are certainly better than traditional medicines in terms of response if given in properly selected patients.
There is no such maximum cummulative dose for biologicals.
Regards
Biologicals are better
Detailed Answer:
hi
biologicals are certainly better than traditional medicines in terms of response if given in properly selected patients.
There is no such maximum cummulative dose for biologicals.
Regards
Above answer was peer-reviewed by :
Dr. Nagamani Ng
I got test of FIBROSCAN after usage of quantity as described above which makes around cumulative 2 gm. I am getting LFT / KFT test regularly and those are normal.
1. Can i take 2gm more safely without going to BIOPSY, if LFT/KFT is being monitored ?
You had also confirmed that increased susceptibility to get new infections with SCAPHO injection due to suppression of immune system.
2. So, If i am getting other infections very easily, will it be difficult for my balance life ?
3. Is SCAPHO is having any serious life threat side affects ?
4. Am i need to take SCAPHO injection life long ?
Sir, Kindly reply for four points related to my problem
Brief Answer:
Answer to specific queries
Detailed Answer:
hi
You can take 1.5gms to 2 gms of methotrexate with proper monitoring without any immediate need for liver biopsy.
Biologicals can increase susceptibility to infections but this risk is with every immunosuppressive i.e even with methotrexate/ folitrax. These immunosuppressives should be avoided in those with life threatening infections like Tuberculosis (TB) or past history of TB due to risk of reactivation Or hepatitis Or co-infection with HIV. I was refering to these serious infections.
In general biologicals are quite safe and do not have life threatening side effects.
Duration and frequency of treatment would depend on the response to treatment.
Regards
Answer to specific queries
Detailed Answer:
hi
You can take 1.5gms to 2 gms of methotrexate with proper monitoring without any immediate need for liver biopsy.
Biologicals can increase susceptibility to infections but this risk is with every immunosuppressive i.e even with methotrexate/ folitrax. These immunosuppressives should be avoided in those with life threatening infections like Tuberculosis (TB) or past history of TB due to risk of reactivation Or hepatitis Or co-infection with HIV. I was refering to these serious infections.
In general biologicals are quite safe and do not have life threatening side effects.
Duration and frequency of treatment would depend on the response to treatment.
Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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