Why I Chose to Treat with Biologics
Choosing a psoriasis treatment can be overwhelming, daunting, and intimidating. You can do your research and advocate when you have the courage to do so, but ultimately it feels like we're left to our doctor's recommendation and insurance approvals.
First things first
The first stop in psoriasis treatment is through topicals - it also appears to be the safest and most popular. Topical ointments didn't work for me.
First of all, I am not a small guy. It is humorous that my last name in French translates to petite. I could easily use an entire tube of ointment to cover the plaques that take up three-fourths of my body.
Not to mention that it takes a lot of time to apply all that gunk. Then, after I did drain the tube and covered each spot, I was left greasy and sticky. So, I had two options: wrap myself in plastic wrap like leftovers or get grease stains on my furniture, clothes, and anything else I needed to touch.
Exploring treatment options
The next best choice seemed to be phototherapy. I did this for a while and can say it was moderately effective. I never reached clearance, but my plaques were subdued and I had much less flaking and discomfort.
The downside was that it wasn’t sustainable with my schedule or finances. To keep up with any results, I visited my dermatologist 2-3 times a week and paid a $35 copay each visit. That adds up quickly!
I then moved on to talks about methotrexate with my derm. A pill that can make my psoriasis dramatically improve? Sign me up! Wait. It can take a toll on my liver. Well, that isn’t going to work for personal reasons and family history.
Living, suffering, and learning
I spent over a decade rooted firmly in my decision to let my psoriasis take my skin over because rough skin wasn’t worth having nervous system disorders or spending enormous amounts of time slathering myself in ointments and cream for little results.
I also couldn't justify spending a fortune or compromising my already-downtrodden liver. My body knew I had given up and took full advantage. My twenties were full of cracked, bleeding, angry skin.
My skin had some serious beef with me. It wouldn’t let up. I was in a constant state of flare for 10 years.
It ultimately starts on the inside...
Finally, I educated myself. I found out things that dermatologist after dermatologist had never told me. Psoriasis is an autoimmune disease. Psoriasis is associated with cardiovascular disease, eye disease, obesity, diabetes, and even cancer.
The inflammation of psoriasis is not just on the skin, it is on the inside too. I was so worried about finding something to make the outside better that I didn’t realize that I also needed to make my insides better.
That is when I decided to take another look at injectable biologics. I chose not to live in fear of what some fast-talking commercial deity said and instead look at real studies done.
What does the research say?
I found that these medications weren’t as petrifying as I made them out to be. One review of the oldest biologics on the market in relation to incidences of demyelinating disease (fancy word for nervous system disorders) found the following...
In clinical trials: 6990 patients had received treatment with etanercept with one reported case of multiple sclerosis; 5204 patients were treated with adalimumab with no cases identified and 2322 patients were treated with infliximab with one case of demyelinating polyneuropathy. Outside of clinical trials: 19 individual cases of demyelinating disorders from TNFi treatment have been reported.1
There is a risk anytime you take a medication, even something as familiar as over-the-counter pain relievers. I weighed the risks and determined that the benefits would be much more significant than the threats. Those were odds I was comfortable with.
The decision to treat with biologics
If I left my disease untreated, I was taking a chance of developing some very debilitating conditions because of the inflammation. The tricky thing with psoriasis is that what works for one person doesn’t always work for someone else when it comes to treatment.
Just because biologics are working great for me doesn’t mean that would be the case for another sufferer.
Don’t ever feel pressured or obligated to do one treatment or another, but do push yourself to research and talk to your doctor to come up with a plan you are comfortable with.
Does your psoriasis skin feel out of control? How are you managing?