How Do You Decide What Biologic To Start?

With regards to Rheumatologist [here in Australia they are currently the only entity that can prescribe PBS approved i.e. ‘discounted’ Biologics or Similar Biologics] has to date discussed with me the target IL & TNF.
However having internal genital psoriasis, to have any form of quality of life restored, [waiting for my 4th Biologic] I have to try anything & everything otherwise…..
I participate in four PsA - Pso forums & I am aware some patients have paused or stopped their Biologic et al. I understand that, as feeling nauseous, lethargic & ‘catching’ any cold, flu etc. is v stressful, swinging from one infection to another is no fun.
I’m also aware Drs & Specialists are still not clear on which IL or TNF are ‘rogue’ & causing our bodies response. It’s very much a trial & error approach. So we must demand these health professionals should be trained ‘properly’ & ‘thoroughly’ in psoriasis. Not only being able to spell it, but to have intimate knowledge, which is an ever moving & evolving knowledge base, of its manifestations, it’s general & psychological impact both to the individual but the whole family.
Harvard research has shown that every ten years, better than 50% of what we were taught or learnt, is now either wrong or superseded in a major manner. Part of the training should include EQ, they typically have a high IQ, however without EQ trying to interact with humans I.e. patients, is flawed at the outset. They used to call this perspective ‘bedside manner’, both my wife [a health care professional] have had to articulate this aspect to Drs endeavouring to treat us or our family. Admittedly in our cases they were not aware they had this important shortcoming, & thus were grateful. Just shows we have serious issues with the training of our Drs > specialists.
Five decades of genital Pso has left me very perplexed with what some call ‘modern medicine’, it’s an oxymoron from my perspective.
Anyway let’s get the conversations happening…….

Hello , Sometimes I just feel like a guinea pig, but I do believe my health care team is doing the best for me. The one thing I have heard over the years was that I have the worst case of psoriasis they have ever seen. I stump them. There is so much that is not known about this disease.


I do say that treatments have improved significantly over the years. I remember that stinky tar medication. I can still smell it 60 years later. I do think that one day there will be a cure, not in my lifetime. We have had so much improvement. A few years ago, I couldn't even imagine taking a shot that could make me almost clear in 3 months.


Trust me, I have had more infections over the years than I can count. On and off of medications, changing them back and forth, in and out of hospitals. It has been a journey.


Thanks for sharing so much great information as always. Do you think a cure is in the pipeline for us?


Diane (Team Member)