Methotrexate and Sulfasalazine

TheSquire

Hi, just wondering is anybody on these? Just started MXT today having been on SS solely for 2 yrs. My rheumy wants me on both but I'm reluctant as I'd like to see how MXT works initially before adding SS (perhaps unnecessarily).

How have they been going for you?

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noddingtonpete

Hello @TheSquire and welcome to the Community. We are a friendly and supportive group and I hope that will be your experience as well.

I understand that you are currently on Sulfasalazine and about to start methotrexate. There are are many people on here who take methotrexate so I am sure that they will share their experiences and support with you. From what others have posted I think you need to persevere taking them for a couple of weeks until you get used to them, but have a look at the following from our website, hopefully it will help.

https://www.versusarthritis.org/about-arthritis/treatments/drugs/methotrexate/

and

https://www.versusarthritis.org/about-arthritis/your-experiences/your-questions-answered/your-questions-on-methotrexate/

Please keep posting and let us know how you are getting on and I am sure that others will share their support and experience as well.

With very best wishes,

Peter (moderator)

jamieA

Hi @TheSquire

I've been on sulfasalazine since October 2020 when I was diagnosed with psoriatic arthritis. MTX was added in February 2021 and then the adalimumab biosimilar Amgevita was added in July 2021. I felt a significant improvement in my condition by September 2021. I don't like taking drugs so in February 2023 asked my rheumatologist if I could cut back and she agreed to reduce the sulfasalazine from 3gms to 2gms daily. About a month later I had my worst flare since I started the combination of all 3 and had to go back up to 3gms. My rheumatologist said the drugs work together and give a better outcome than each on it's own. I think the term is synergistic or as she descibed it 1+1+1>3.

I know everyone is different so it may not be the case for you but that's my experience. I hope you get a combination that works for you.

TheSquire

Thanks Jamie,

Its great that it seems to be working for you. I actually think its PA i have as well although its never been labelled.

Have you had any side effects from the treatment?

jamieA

Hi @TheSquire

I was a fit and healthy retiree then I probably had covid in March 2020 and suffered repeated chest infections afterwards. I was then diagnosed with PsA that October and then pneumonia in November 2020. I was put on MTX in February 2021. I then had a heart issue in May 2021 - atrial fibrillation and tachycardia. I had no previous history of any of these. I then had tachycardia again in October 2021, was admitted to hospital and was seen by a rheumatologist - not a cardiologist. The rheumatologist halved my MTX from 20mgs to 10mgs and I didn't have a repeat until 2 weeks ago. That episode 2 weeks ago was put down to a reaction to an injection of contrast agent I had during an MRI scan. I asked my cardiologist whether the original AF and tachycardia was caused by the MTX but he said it was more likely because of previous covid infection. I have my doubts though as why would the rheumatologist reduce my MTX.

Other than that conjecture on my part I've not had any side effects that I know of. I'm very careful as I realise that I'm now immunocompromised so am extra careful with cleanliness and avoid crowded areas.

TheSquire

Thank you for your reply, it was very helpful.

I'm sorry to hear that you have had such a bad run of health recently but stay positive.

Hopefully, things settle and better times are ahead.