MTX - when are other drugs added to the mix?

nanarose

Hi everyone, I hope you are all managing to keep warm during this freezing cold spell. My thermometer is saying -11 just now! x:rudolf

I have PsA and I am currently taking Mtx 25mg, and started treatment back in June.
I have felt quite a benefit from it, but in the last few months I have developed new swellings in different joints, ie my wrist and new fingers, and my toes, other fingers and knee are still swollen - they never really cleared up.

I am due to see my Rheumy nurse just before Christmas - the question I would like to ask is whether the mtx is now working as it should, or perhaps I ought to be getting something else added to the mixture?

I already have fused toes, and a fused knee, as I was diagnosed too late, and the damage was already done, but I certainly don't want my wrist to go that way too.

I would value any advice/suggestions, as I'm unsure as to what level of inflammation the Rheummy department consider as 'under control'.
I don't want to go charging in there demanding this, that or the other, but also, I do feel that I have the right to know where my treatment goes from here.

Thanks folks. x

mp1952

Hi

I am on Mtx 15 mgs and it is no longer as effective as it was (as proven by increased pain and swelling in my joints and raised CRP and ESR levels). It has been gettin gworse over several months now, so I am therefore going to start an anti-tnf drug (Humira) very shortly. (in fact I am attending the 'anti-tnf clinic' tomorrow to get the ball rolling).

I am sure other peeps will be along soon to give you some further advice.

Best wishes

Marion

dreamdaisy

We're all different. It's one of the 'joys' of this rubbish that what works so well for one person does very little, if anything, for another. I too have PA, (14 years in, diagnosed for 4) and am currently taking humira (40ml injected fortnightly), meth (17.5ml injected weekly), sulpha (6 tablets per day), naproxen (2 tablets per day) and oral steroids (now on a paltry 7.5mg per day). There are other drugs too, including pain dullers of increasing strength. Is my version of PA controlled? I think I have to say no, not really. My blood results are marvellous, which makes soooo many of the 'technical' people so very happy, but for me (who has to live with it) it's very different: I still flare, am in continual pain and still on sticks, and have now increased to 35 affected joints.

How should a drug work? I no longer know: I know not to expect wonderful results - they are for others, not me. Meth alone is pretty pointless but it can, and does, work well for some. I suspect you may need some more pharmaceutical suppport, but that is for your rheumatologist to decide. Keep notes of how you are being affected, and talk to him/her at your next appointment. I wish you well. DD

Wonkylegs

HI

I think your questions are very reasonable and would show that you are wanting to take control of your condition rather than just put up with it.

If you want to talk through the best ways to ask these questions I know that the Arthritis Care helplines people are great.

I don't have much knowledge of PA, but I know that for me, it became obvious from the blood results and how I was feeling that what I was currently taking was 'not enough' to enable me to live my life as I wanted to. THere are lots of drugs which can be used in combo with MTX, so it is likely that they wil try several before they find what really works for you.

good luck
wonky

nanarose

Thanks for the replies folks! (I wrote ladies, but sometimes the forum names don't give much away about the gender of the person! )

Sorry DD that you are one of those who don't respond well to medication. That is some concoction you have there. :?

Marion, good luck with your anti-tnf meds when the time comes; I hope they help you. May I ask how long you have been on mtx?

Wonky, that is exactly how I feel - I want to be the person 'in charge' of this ailment, disease whatever you want to call it, and not just be a passenger.

I am so much better than I was before, but the new swellings and pain are alarming me a bit, I admit.
I also have the usual painkillers, paracetamol. co-codamol, and tramadol. I am 'allowed' to medicate for pain as I see fit, with the obvious safety rules. I also take Amitriptyline 25mg or up to 50 mg.

The thought that I could suffer more damage because the nurse won't give me another med to add to the mtx, because I've only been on it for 6 months is worrying me. I won't be seeing the Rheumatologist herself for quite some time yet.

I shall do as you say and keep a note of what's happening, and see what the nurse says. The rheummy dept. have been really good so far, so here's hoping they carry on the good work.

Many thanks. x