Had my rheumatologist tell me he wants to put me on biologics, I told him to pound sand.
I will tell you something else that might work for you depending on your genetics.
It took me awhile to find someone to prescribe Low Dose Doxy. It did wonders for me. BUT I won’t take it all 12 months. You could try to for 30 days to see what it does for you. I still am not taking Plaquenil which is the lowest risk of the Rheum. meds. I switch between Low Dose Naltrexone, nothing, and Low Dose Doxy.
It is all just experimentation until you find something that works for you. I am still stunned that I made my Psoriasis completely disappear with Low Dose Naltrexone.