Psoriasis support - methotrexate vs. soriatane

Author

methotrexate vs. soriatane

Phillip

2006-04-20, 6:19 pm

Hello,
I am 26 years old and have been dealing with psoriasis since my freshmen
year of college. It has progressively gotten worse. My doctor's have tried
almost every cream with me but I have so many spots, mainly on my back now,
that it's impossible for the creams to really be a solution. I've also
tried UV but I burn very easily and it's painful to be burnt all the time on
my back. My scalp is also very bad too. I was on Methotrexate for a 1 1/2
years when I lived in Dayton. My doctor down there didn't really even
hesitate to put me on it. I cleared up 100% rather quickly. Well, when I
moved to Cleveland my new dermatologist was very concerned about me being on
methotrexate at such a young age. He told me of the liver biopsies I'd have
to do in a couple years time and I didn't like the sounds of that. He tried
putting me back on creams and gave me Derma-smoothe for my scalp. I hate
using that stuff! He then told me about trying me on Soriatane. From what
I've read on their web site the drug looks pretty good. Some of the side
effects sound like a real pain though. Dry mouth, peeling skin, chapped
lips. But a lot of people have success clearing their psoriasis with it.
But I've also read a lot of posts how Soriatane didn't work for people and
that it's a crap drug. Are there any opinions on this before I see my
doctor in a couple weeks? Thanks.

~ Phil

Grandpa Chuck

2006-04-20, 6:19 pm

On Thu, 20 Apr 2006 20:14:14 GMT, "Phillip" <p@woh.com> wrote:

>Hello,
> I am 26 years old and have been dealing with psoriasis since my freshmen
>year of college. It has progressively gotten worse. My doctor's have tried
>almost every cream with me but I have so many spots, mainly on my back now,
>that it's impossible for the creams to really be a solution. I've also
>tried UV but I burn very easily and it's painful to be burnt all the time on
>my back. My scalp is also very bad too. I was on Methotrexate for a 1 1/2
>years when I lived in Dayton. My doctor down there didn't really even
>hesitate to put me on it. I cleared up 100% rather quickly. Well, when I
>moved to Cleveland my new dermatologist was very concerned about me being on
>methotrexate at such a young age. He told me of the liver biopsies I'd have
>to do in a couple years time and I didn't like the sounds of that. He tried
>putting me back on creams and gave me Derma-smoothe for my scalp. I hate
>using that stuff! He then told me about trying me on Soriatane. From what
>I've read on their web site the drug looks pretty good. Some of the side
>effects sound like a real pain though. Dry mouth, peeling skin, chapped
>lips. But a lot of people have success clearing their psoriasis with it.
>But I've also read a lot of posts how Soriatane didn't work for people and
>that it's a crap drug. Are there any opinions on this before I see my
>doctor in a couple weeks? Thanks.
>
>
>~ Phil
>

My derm who has been in practice for many years and was the head of
the derm surgery department at our university for a number of years
put me on Methotrexate nearly two years ago. I asked him about doing
biopsies. He said with the reliability of blood test they have today
he does not think they are necessary. At first I had blood drawn every
week; then every two weeks; and now for the past year it has been once
a month. All of the tests have been good and it cleared my plaques
about 95% or so pretty quickly. I have one stubborn one on my lower
back that doesn't seem to want to go away and a golf ball sized one on
my right rib cage that is fading slowly. I'm hoping that now with warm
spring weather finally here and me spending more time outside the
sunlight may help those disappear too.

When I was at the derm clinic at the university on another matter the
doctor that heads it now told me to not use my UVB cabinet at all so
long as I am on Methotrexate.

Good luck to you with whatever you decide to do. If you want to go
back on the Methotrexate it looks as if you will need to find a
different derm.

--
Grandpa Chuck
-ô¿ô-
~

The following information is given with the utmost respect
for the armed forces and civilians who have died in the
current war in Iraq. According to http://icasualties.org/oif/
The number of Americans killed in Iraq as of April 18, 2006 is 2,378.
Americans wounded = more than 17,469
United Kingdom = 104
Other = 105
Iraqi deaths are probably in excess of 100,000.

Today, April 20, 2006 it has been 1086 days since Bush declared,
"Mission Accomplished in Iraq."
And some people still believe what he says.

CyberSpiff

2006-04-20, 6:19 pm

Phillip wrote:
> Hello,
> I am 26 years old and have been dealing with psoriasis since my freshmen
> year of college. It has progressively gotten worse. My doctor's have tried
> almost every cream with me but I have so many spots, mainly on my back now,
> that it's impossible for the creams to really be a solution. I've also
> tried UV but I burn very easily and it's painful to be burnt all the time on
> my back. My scalp is also very bad too. I was on Methotrexate for a 1 1/2
> years when I lived in Dayton. My doctor down there didn't really even
> hesitate to put me on it. I cleared up 100% rather quickly. Well, when I
> moved to Cleveland my new dermatologist was very concerned about me being on
> methotrexate at such a young age. He told me of the liver biopsies I'd have
> to do in a couple years time and I didn't like the sounds of that. He tried
> putting me back on creams and gave me Derma-smoothe for my scalp. I hate
> using that stuff! He then told me about trying me on Soriatane. From what
> I've read on their web site the drug looks pretty good. Some of the side
> effects sound like a real pain though. Dry mouth, peeling skin, chapped
> lips. But a lot of people have success clearing their psoriasis with it.
> But I've also read a lot of posts how Soriatane didn't work for people and
> that it's a crap drug. Are there any opinions on this before I see my
> doctor in a couple weeks? Thanks.
>
>
> ~ Phil

Check out the NPF site (http://www.psoriasis.org/) and the Soriatane
site (http://www.soriatane.com/) before making any decisions. If you
plan on having children be sure to read the part about birth defects and
how long Soriatane stays in your system, especially if you consume
alcohol while taking it.

Soritane worked well for me, but there were side effects. The chapped
lips and dry mouth were easy to solve, but I had issues with depression
that required close watch. I'd suggest talking with your derm about
alternatives and about what you've read on the side effects to make an
informed choice.

There are other choices e.g. Enbrel and Humira that don't have the major
side effects of Soriatane and have worked well for many people. On
Soriatane I went from 60% coverage to 30%. After 2 years on Soriatane I
switched to Humira and now after 2 months of bi-weekly shots am at
almost 100% clear.

-spiff

JXStern

2006-04-21, 1:20 am

On Thu, 20 Apr 2006 20:14:14 GMT, "Phillip" <p@woh.com> wrote:
>Hello,
....
>But I've also read a lot of posts how Soriatane didn't work for people and
>that it's a crap drug. Are there any opinions on this before I see my
>doctor in a couple weeks? Thanks.

Phil, see the excellent message from CyberSpiff.

No drug works for everyone. Soriatane at least works well for some
people, but it certainly has side effects. Soriatane is a big no-no
for young women, and there is serious concern even about young men who
might want to (or accidentally!) father a baby. If you take even a
tiny drink of alcohol, those concerns suddenly extend years after you
stop taking the drug.

In this day and age I'd certainly look to the TNF blockers Enbrel and
Humira, and possibly a few of the other current "biological" drugs,
which *are* expensive, are injection-only or even infusion (office
procedure), and certainly have their own side-effects, but the overall
profile of effectiveness and safety is better than Soriatane or even
methotrexate, it seems to me.

Just another thought here, that there seem to be several
second-generation psoriasis drugs coming down the pike, with any luck
two, three, maybe four years out. So any drug you take now -- even
methotrexate! -- may only have to keep you going for that long. Yeah,
the prospect of fifty years on mtx should scare your liver, though on
the low, psoriasis doses it seems some people go that long, and even
the biopsies are now replaceable by blood tests, in the opinion of
some. Heck, mtx and a convenient blood test is not a bad treatment.

Hope that helps.

J.