Welcome, Sue Plaster! / methotrexate and nodules

[Guest guest]

A belated but warm welcome, Sue! I'm happy you found us, too.

You have had an incredibly difficult few months. I am very sorry to read

about all of your hardships.

Regarding the methotrexate and the nodules:

" Unique to this drug in RA is the accelerated growth of rheumatoid

nodules, often in sites where they would not usually occur. The

mechanism for methotrexate nodulosis is unknown. "

Source:

http://www.medical-library.org/journals3/Rheumatoid Arthritis.htm

" Sometimes, in the case of the use of methotrexate, nodules may become

worse despite improvement in other manifestations of RA. "

Source:

http://www.coloradohealthsite.org/chnqna.html?Arthritis?Symptoms?2014

" Treatment with methotrexate may enlarge these nodules. (p. 219) ...

An accelerated nodulosis has been estimated to occur in approximately 8

percent of RA patients treated with MTX. Histologically, these nodules

are not different from rheumatoid nodules. They heal with

discontinuation of MTX and reappear with reintroduction. They also may

develop in the heart or in the lungs. (p. 341) "

Source:

" Rheumatoid Arthritis: New Frontiers in Pathogenesis and Treatment, "

edited by Firestein, Panayi, and Wollheim; Oxford University Press;

2000.

Rheumatoid nodules can recede, but they often don't.

Is your rheumatologist considering putting you on Arava instead of the

methotrexate or adding it?

[ ] New member

> Hi,

>

> I've just joined this group today and am looking forward to hearing

other

> members' experiences with rheumatoid arthritis. I'll be 63 next month,

and

> live in piedmont North Carolina.

>

> Within a year I was diagnosed with shingles, rheumatoid arthritis,

bleeding

> ulcer and anemia from Aleve, and breast cancer. It was really a rough

year

> for me. The worst was the RA, worse even than the breast cancer,

because it

> was caught early by my annual mammogram. It was Stage 0 ductal

carcinoma in

> situ. I had a lumpectomy in March 2002, followed by 35 radiation

treatments.

> Now I'm just hoping it doesn't come back.

>

> I have Type 2 diabetes, so the rheumatologist at first diagnosed me

with two

> frozen shoulders, which is common in diabetics; and diabetic limited

joint

> mobility syndrome, which affects mostly the hands and is usually

painless.

> He sent me to physical therapy, which did no good and was just torture

to

> have my arms moved into positions they didn't want to go into. I kept

having

> unbearable pain, so I called the rheumatologist and he called in a

> prescription for Vioxx. That didn't help any more than Celebrex, which

I'd

> already tried. I called him again about the pain, and this time he

really

> got it. He got me in to see him in two days. Bloodwork showed lots of

> inflammation and a positive rheumatoid factor, so he diagnosed me with

> rheumatoid arthritis. X-rays of my hands showed no damage.

>

> All of this time I was taking a double dose of Aleve.

>

> I was put on 7.5 mg of methotrexate a week, along with prednisone to

help

> with the pain until the MTX had time to work. After three months, the

dosage

> was increased, and has been increased periodically until now I'm at 15

mg.

> My last CBC showed that my white blood cell count was low. I have been

off

> the prednisone for about a month and a half. I'm still having lots of

pain,

> especially in my knees.

>

> I have also developed rheumatoid nodules on both elbows. I also have

what I

> think is a nodule on one foot, but the rheumy said he didn't know what

it

> was. Now I think I'm getting them on the tops of both hands and on one

index

> finger.

>

> Now I'm supposed to decide if I want to take Arava. I would like to

know

> about others' experiences with this medication. What I've read so far

is

> very scary.

>

> I would also like to know if any of you have rheumatoid nodules. Can

they be

> caused by methotrexate? Do they ever just go away? My aunt, the only

other

> person in my family with RA, had huge nodules on her elbows.

>

> I'm so glad to have found a support group for this terrible disease.

>

> Sue