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.
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