Rea spotted this bit of news today about biologics, which  can be used  to treat special cases of Birdshot where other drugs fail.    It opens up another possibility if the more usual treatments fail or if you suffer from very bad side effects.  We know of cases where  adalimumab, infliximab have been prescribed.

Doctors.net.uk Medical News

As many as one in 500 adults should be receiving a new generation of “biologic” drugs to treat inflammatory diseases, according to new guidance published yesterday.

The designer drugs are more expensive than standard treatments for diseases such as rheumatoid arthritis – but can help many patients, according to the National Institute for Health and Clinical Excellence.

Biologic drugs are made through recombinant DNA technology and include treatments such as adalimumab, etanercept, infliximab, rituximab and abatacept.

NICE has issued its guidance to commissioners, such as primary care trusts and, increasingly, GPs.

It says the drugs should be given to patients for whom conventional treatments do not work – or who suffer side-effects.

And it blames funding constraints and lack of nurse specialist resources for limited use of the new drugs.

On average 190 in every 100,000 adults should be receiving the biologic drugs for inflammatory conditions, it says.

GP Dr Carl Parker, from Hartlepool, said timely use of the drugs could prevent patients deteriorating.

He said: “There is a large and potentially increasing demand for biologic drugs. However, the unrestricted and inappropriate use of biologic drugs could place a large financial burden on the NHS.

“Therefore it is important that commissioners manage their budget proactively to ensure that all eligible patients have access to the drugs in accordance with NICE guidance.”