May-Jun '08 | briefing | mail | interviews | articlespsorchat |  don't say this | flaker creativity | flakers' jargon | other places | archives | send mail | ed dewkesearch | acknowledgments | legal stuff | Flake: Confessions of a Psoriatic  | 2008 Ed Dewke

Retrospective on Treatments Progression
from Scott G.

Ed:  I too share many experiences with you, albeit, I was younger, now 48, started about 12-13.  Progression was continual.  Westcort Cream  (.05%) was my savior for so many years in the 80s.  Little hard to get doctors to write it for me today.  Have Used Tridesilone [a.k.a. Desonide] for years.

I too have always responded well to most treatments offered, if I stayed on them. Started MTX [methotrexate] way back when, late 80s early 90s and quickly was afraid and stopped.

Light and Tar always worked out well for me, but who can stay "tarred" up so much, especially at that time a US Army soldier?  We will not talk about the fight to stay in the Army from 1980-81 when it really broke out in training.

I first was on Raptiva in the studies; I responded well, I was listed as SEVERE plaque P.  Thankfully, unlike you, never a nail problem or Pustular (although I believe my Psoriasis is why I am sort of a puss factory, more boil type).

Raptiva cleared me 90% of what the study derm noted was over 80% body coverage (this happened long after I was a soldier).  Cleared my heels after over a year better than the Humira I am on now. The Humira for me is a 98% clear rate, but I have many other problems and was thinking of going back to Raptiva.  Humira has brought out diverticulitis quite awful for me. Looking at surgery, as I am constantly on antibiotics 3-5 times a year for 14 days, the strong ones you know, the ones I do not want to stop working.

So, you write nothing YET, in updates about your Humira usage.  Are you still on biologics, and if you do not mind, which one now, why you chose and  I believe all these help some people, but I believe the Humira is being prescribed too quickly and this will certainly be one of the bio's that will end up not being the best health selection 10 years down the road.

Thanks, I love your wit in writing.  –Scott G.

*****

Ed’s Response:   Hi Scott.  Thanks for writing.  We are — aren’t we — both living laboratories for the pharmacology of P.  Comparing us also reinforces the common observation that psoriatics are highly individualized when it comes to type and degree of psoriasis involvement and the way we respond to treatments and drugs.

Humira may have been prescribed too quickly for you, but based on my 1.5 years using this biologic so far, I wish I’d have tried it earlier.

Am wondering about your diverticulitis.  Have your doctors directly related this to Humira use?  I ask because there’s no “specific” mention of this condition in the prescribing information.  Also, as we both know, virtually ALL the current biologics for P come with some increased risk of infection.  If you have migrated through more than one biologic (or other systemic) with little or no “rest time” between prescriptions, you have sustained a risk of infection that may be more associated with the long run on systemics in general than a specific consequence of Humira use.  My 2006-2007 run of bad luck with MRSA infection was probably catalyzed by general immune system suppression from years of using methotrexate, cyclosporine, Enbrel, Raptiva and, now, Humira.

Raptiva cleared my skin and nails better than any other systemic — another similarity between your case and mine — but it did nothing to improve my psoriatic arthritis, which is why I ended up using Humira.  I’m 99.9% clear on Humira and my joint pain has been only a memory through the last year.  I’m trying to be realistic and telling myself this won’t last forever, but let me tell you, I’m sure getting used to it!  -Ed

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