I ask in my 2nd biologic. Both have had great results for me but like another answer I had to try methotrexate first. It was so bad on my liver that I had to have a liver biopsy 7 months after I quit it. But after that it was just a matter of doctor prior authorizing it because of liver functions in other meds. Insurance still demands a yearly prior authorizing but the doc is great about that.

I have tried Methotrexate twice but liver function tests results were getting higher and higher each time which was a massive shame because I was starting to a big reduction in psoriasis and PA as well

I am currently using Skyrizi. It has calmed the psoriasis down quite a bit. When the weather changes I am still having some arthritis pain.

For me in the UK multiple years you have to basically try everything else beforehand. I only just started Methotrexate 6 weeks ago. I live in London so might be quicker where you are! Good luck