Q: I have been diagnosed with psoriatic arthritis and have been suffering from joint pains and back stiffness for the last year. I have scalp psoriasis for the last 4 years. I have not taken any medicine for scalp psoriasis but for psoriatic arthritis, the doctor has suggested Remicade injection, which I been told is very expensive. Is this right? Will Remicade help in curing psoriatic arthritis and psoriasis?

A:Psoriatic arthritis (PsA) and scalp psoriasis are signs and symptoms of the same disease and hence should be treated by a co-ordinated therapy. There are many conventional treatments available such as cyclosporine, methotrexate, vitamin A derivatives, psoralen plus ultraviolet light (PUVA) etc. If these conventional therapies fail, then one needs to use other agents such as infliximab (sold as Remicade) and etanercept (sold as Enbrel). Remictade therapy is quite expensive since it is imported and hence its price is not regulated. A 100mg injection can cost about Rs. 30,000. The usual dose is 5mg per kg body weight. Thus you will need to take 3-4 injections per session at least 4 times. The total cost of four therapies will be about Rs. 30,000 x 3 = Rs. 90,000 x 4 sessions = Rs. 3,60,000. Etanercept (Enbrel) is less expensive. A 25mg injection costs Rs. 9,000 or so. The dose is one injection two times per week. It is marketed by Wyeth in India.