Hoping Amevive Will Replace Methotrexate
from Krissie R.

Ed:  My husband and I have really enjoyed reading your site today.  It's nice to see that other people with P see some of the humor out there, which is what keeps us going.  It's also great to see a fellow Kentuckian doing great things out on the web by giving us a reference site that's so easy to follow and informative.

My husband, Don, has plaque psoriasis over about 60% of his body, concentrated on his back and head.  Now 35 years old, he began to "flake" almost 15 years ago.  He's sort of a walking encyclopedia of OTC "treatments," as well as wives' tales of how to ease the itch.  He did not have health insurance until last summer, and only began serious treatment in November when he began to show signs of PA in his hips.

We were lucky that our GP put us in touch with a very caring doctor at the Lexington Clinic.  She laid out several options for us, and Don chose methotrexate plus fluocinonide for his scalp, rather than hoping topicals would work.  This, in many ways, has been as trying as the P itself.  Don was up to 25 mg a week by February of this year, and was having fairly serious side effects the day of and day after medicating.  He was exhausted, nauseous, and generally wrung-out, but his skin showed dramatic improvement.  The lesions did not get smaller, but the plaque went away, and the lesions were becoming "skin colored" from the center out, which the derm said was what we were looking for.  She also made comments like, "Hey! The normal skin itches for a change!"

Last month, at his checkup, his liver counts had become quite elevated.  The derm cut his dosage back to 12.5 mg, and began to tell us about Amevive.  She recommended that when Don's liver counts got too high, she would change treatment to a once-weekly intramuscular injection in her office.

Just today, Don’s derm determined that his liver counts were high enough that we needed to stop treatment.  We then got our first call from the Amevive representative, who is going to try to put the regimen through our health insurance.  Fortunately, Don works for a company that has a self-funded insurance program, so we think we've got a good shot of getting approval.  His next derm appointment is May 5, and we're hoping to hear something by then.  As well, the Amevive rep said she would be in touch with us directly as soon as she hears anything.

I will let you know what we find out about the program, and how it works.  So far, we're hopeful, and things seem to be going well, but of course, Don hasn't received any injections yet.  Keep your fingers crossed!

Again, many thanks for the excellent site!  -Krissie R.

*****

Ed’s Response:  Glad you and Don found us, Krissie — and thanks for the kind comments.

I do hope all goes well with the insurance and Don gets his crack at Amevive.  I feel good about Don’s prospects because his derm proved to be very observant and careful about his methotrexate regimen.  She’s likely to be just as observant and careful when Don takes Amevive. 

Please do keep us apprised.  -Ed

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