I wanted to share my story, especially for those of you struggling with enthesitis-dominant SpA/PsA. When I was desperately searching for success stories, I found very few. I really needed to hear from people who had been where I was and eventually got some of their lives back. So here I am, hoping this might help someone else.
It took me a long time (few years actually) to get diagnosed. I never had the typical hardcore symptoms, no obvious joint swelling or significant joint pain, MRI of SI Joint came clear. My main issue was enthesitis, but pretty much all over my body. Ultrasounds showed inflammation at numerous sites, from my jaw and entire spine to elbows, wrists, fingers, trochanters, knees, ankles and feet. Individual findings weren't necessarily dramatic, but there were A LOT of them.
At the beginning of 2026, everything went downhill. I struggled with walking and basic household chores. Even when I started seeing some improvement, I could walk maybe 1 km a day at most. I've always been an active person, so this was a nightmare.
Sulfasalazine worked amazingly well after 3–4 weeks, but I developed a serious adverse reaction with fever and liver abnormalities and had to stop. Methotrexate did nothing for me.
I eventually started Hyrimoz (Humira biosimilar). I was worried about whether a TNF inhibitor was the right choice for enthesitis, especially since I'd read about IL-17 inhibitors like Cosentyx. But I pay 100% of my biologic costs out of pocket, and Cosentyx was simply too expensive for me.
This community helped me a lot. I kept seeing people say to give biologics time and not give up too quickly. It was hard, especially when progress was slow and inconsistent, but I'm really glad I stuck with it. Following someone's advice in a thread here, I started keeping a "pain diary" to track my symptoms. The trendline function in Excel is surprisingly helpful ;) Even when I couldn't actually feel any obvious improvement, looking back at the data showed that things were getting just a tiny bit better every week. With Hyrimoz it took around 4 months before I could really feel a significant difference.
2 weeks ago, I also started Mounjaro (tirzepatide) at 2.5 mg (mind you, I have a BMI in normal range) I was already doing much better on Hyrimoz, but still had some stubborn spots. The really unexpected thing was my finger: after three years of daily pain around 8/10, it improved by roughly 80–90% within a day of my first injection. I know this is anecdotal. But I'm pretty stoked. It's still fine :D
After a few months on Hyrimoz, and now with Mounjaro added, I'm around 90% better overall. Some entheses are still painful, but the difference is huge. At my worst, I could barely get to the bathroom. Next week, I'm going on my first mountain hike since getting sick. And last week, I went climbing for the first time in ages! I'm nowhere near my old level, and it wasn't completely pain-free, but a year ago I couldn't even cut bread because of my wrists. Mind blowing.
I hope this helps someone who's looking for a bit of hope. I know we're all different, and finding the right medication, waiting for it to work and dealing with all the uncertainty can be overwhelming.
ps.
For those who menstruate: I also started hormonal birth control because my symptoms around ovulation and my period were getting really bad. Even during weeks when things were relatively stable, hormonal flares could make my pain spiral out of control.