Do you use apremilast in combination with biologic DMARDs for psoriatic arthritis and/or psoriasis?  

I have used apremilast in combination with a biologic in my practice. Monotherapy with biologics is not always effective in relevant treatment domains in patients with psoriasis and psoriatic arthritis. Then the choices are to switch to a different biologic agent, add a traditional DMARD or consider...

I agree with @Vikas Majithia. By the way, for help with insurance coverage, the insurance subcommittee of the Committee of Rheumatologic Care at ACR has come up with an appeals letter using apremilast with a biologic. Just go to the following link and you can download it: https://rheumatology.org/...