Hi Paul and welcome to KA.
Whether or not to take biologics can be a sticky wicket. Those of us who are on them often have extremely good results and the statement, "It's given me my life back," is common. Yes, they have some frightening side effects, so you need to do your research, look at the actual statistics (and not just headlines in the news) of adverse reactions and truly bad side effects, talk to your doctor and make the decision that is right for you.
I tried to treat my AS holistically for several years, but eventually I was taking 12+ extra-strength Advil every day to deal with the pain (on top of the herbal anti-inlammatories I was taking. That's when my rheumy stepped in and insisted I go on prescription NSAIDS. He feared that the amount of Advil I was taking would kill my stomach. I progressed through five different NSAIDS in a little over 15 months - only Vioxx ever came close to killing the pain, but it gave me a burny tummy. I was diagnosed with ulcers five months or so later and that's when I was recommended for a biologic. Longterm NSAID use can be extremely dangerous for the stomach, and I found that even when I took them with a stomach protector, food, a full glass of water, my tummy would burn. Also, the COX-2 inhibitors (ie. Celebrex), while they do protect the stomach to a degree, taken longterm will inhibit bone's ability to heal as COX-2 is integral to the healing process in fractures, as well as in sloughing off the old bone.
As Sue said, it's probably a matter of phylosophy when it comes to rheumies and which to prescribe first. To my mind, given my positive results with Remicade, my partner's with Enbrel and the positive results of so many others, biologics should be considered as a first line of defence over NSAIDS. Even with the dangers inherent in taking them. I know others will disagree.
I encourage you to persevere with the no starch diet (or at least low starch). It has enough beneficial results to make it worth trying as a part of your treatment plan. But it doesn't work for everyone. Give it a good six to eight weeks before making a final decision.
I believe that a combination of alternative (ie. NSD) and allopathic (ie. biologics/NSAIDS) is the best course for us.
Hugs,
