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  5. I have been suffering from dry, scaly psoriasis for the past 10 years and asthma for 3 years, along with obesity. I have been taking Folitrax 7.5 mg × 2 once weekly for the last 8 years and Folvite 5 mg daily. Recently, I have noticed worsening breathing difficulty despite using the Seroflo inhaler twice daily and Tiate once daily. There has been no improvement in psoriasis, and my asthma symptoms continue to worsen. What should be my next course of management?

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I have been suffering from dry, scaly psoriasis for the past 10 years and asthma for 3 years, along with obesity. I have been taking Folitrax 7.5 mg × 2 once weekly for the last 8 years and Folvite 5 mg daily. Recently, I have noticed worsening breathing difficulty despite using the Seroflo inhaler twice daily and Tiate once daily. There has been no improvement in psoriasis, and my asthma symptoms continue to worsen. What should be my next course of management?

Asked by Male, 35 · 2 months ago

Worsening asthma symptoms despite regular inhaler use warrant a reassessment of your current therapy. Long-term methotrexate use can occasionally lead to pulmonary (lung) toxicity, which may contribute to breathing difficulty. You should consult a pulmonologist promptly to evaluate for possible methotrexate-induced lung toxicity or worsening asthma. Pulmonary function tests (PFTs) and a chest X-ray or HRCT scan may be recommended. Based on the findings, your doctor may modify or discontinue methotrexate and adjust your asthma treatment plan accordingly.
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Other Related topics like...

  1. Evaluation of Current Asthma Control

    • Reassess asthma severity due to worsening symptoms. Consider spirometry or peak flow measurements.
  2. Review and Optimization of Asthma Treatment

    • Consider stepping up therapy, possibly adding biologics or oral corticosteroids. Consult a pulmonologist.
  3. Assessment and Management of Psoriasis

    • Given no improvement with methotrexate, refer to a dermatologist for alternative therapies.
  4. Monitoring and Managing Methotrexate Therapy

    • Regularly monitor liver function and blood counts due to long-term methotrexate use.
  5. Addressing Obesity and Its Impact

    • Recommend lifestyle changes, including diet and exercise, as obesity can worsen asthma and psoriasis.
  6. Coordinated Care Approach

    • Engage a multidisciplinary team: pulmonologist, dermatologist, and dietitian.
  7. Patient Education and Follow-up

    • Encourage medication adherence, symptom recognition, and regular follow-up visits.

Answered 2 months ago

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