When methotrexate doesn’t work

Toffeepop · 7. Aug 2023, 08:17

Hi all, I have RA in ankles and feet. Started methotrexate in March- started on 15mg now up to 25mg and still having flare ups and suffering with plantar fasciitis too. I’ve had steroid injections and that gave relief for 2/3 weeks, self reducing prednisolone work ok’ish but had some side effects that makes me not want to take again. Can’t take anti inflammatory drugs like naproxen/ibuprofen due to another medical condition. Has anyone else not had methotrexate work for them? What other options can I ask for? X TIA X

jamieA · 7. Aug 2023, 08:53

Hi @Toffeepop

When I was first diagnosed with PsA I was put onto sulfasalazine and when that didn't work MTX was added. That didn't work either so eventually the adalimumab biosimilar Amgevita was added and the combination of the 3 has worked for me. However I remember at the time being told that you had to have tried 2 DMARDs that hadn't worked and have 3 swollen joints before the medics would consider biologics. For RA I think they use something called the DAS28 score - Disease Activity Score.

https://www.ouh.nhs.uk/rheumatology/information/documents/EligibilityCriteriaforBiologicsResponseCriteriatoBiologics.pdf

https://nras.org.uk/resource/the-das28-score/