Psoriatic Arthritis Question
This is really more of a Methotrexate question
Psoriatic Arthritis question ask of rusty on 02/18/08
I have recently been diagnosed with Psoriatic Arthritis. I have
had an extensive workup including blood work, MRI’s, X-rays and Dexa Scan. This
was discovered by my orthopedic surgeon when my x-rays showed my right knee of a
70 year old and my left knee of a 40 year old (my current age). He then referred
me to a rheumatologist who ordered the rest of the workup. I have been on
Prednisone for about a month and half. I have also been taking Methotrexate and
Folic Acid as well as Ultram and Flexeril. I have been told that the
Methotrexate is something I have to take for the rest of my life. However, I am
a little concerned about my liver. He told me I would have to have my LFT
checked monthly. I have one more week of the Prednisone to take and then the
Methotrexate should “kick in”. My question is this: do you know of any other
treatment(s) for psoriatic arthritis. I do have a great rheumatologist however,
another opinion would be great. I am just worried about my liver and the long
term use of taking Methotrexate. Thanks in advance for your help.
Psoriasis can be a very tough type of autoimmune disease to manage. Psoriatic
arthritis is as side effect of Psoriasis.
Methotrexate is considered the most effective drugs for treating psoriasis.
Being a chemotherapy drug is does not come with out its side effects. Most of
these come at higher doses of the drug. Proper management of the drug can reduce
these side effects.
Liver function is monitored closely to catch potential liver problems early. It
looks like your Rheumatologist is monitoring closely. Here is a quote from the
American College of Rheumatology web site about metotrexate and liver side
"Methotrexate has been associated with cirrhosis (scarring) of the liver, but
this side effect is rare and more likely to occur in patients who have
underlying liver problems or are taking other drugs toxic to the liver."
Most patients never see problems with their liver even when they have been on
the drug for decades.
It is easy to focus on the side effects of a drug like this but the other side
of the coin is the damage that can happen to your body if the condition is left
treated. I know of a young lady who refused to try Methotrexate until she had
done significant joint damage to many of her joints.
I know some of these drugs can be scary but when compared to the quality of life
issues both now and in the future they are not so scary. If you work well with
your doctor and help him or her manage both the symptoms of the disease and the
drugs used to treat the disease then you have little to worry about.
Here is a link to the National Psoriasis page on treatment options for your
condition. This should give you a good start at understanding some of the
treatment options. Take notes if you need to because you and your doctor should
work together at developing a treatment plan. If you see something there write
it down and ask you doctor about it.