My experience with MTX

[Guest guest]

J=Here is a synopsis of my story:

My regular doctors treated my inflammation with Celebrex or Voltaren. No one

diagnosed anything, but I suspected PsA as I'd had psoriasis for decades. Later

when my thumb (right hand and of course I'm right handed) got very badly

inflamed, I went to my first rheumatologist, he did bone scans, and lo and

behold my thumbs (and parts of feet lit up). He first treated my PsA in two

thumb joints with cortisone injections. Then when more joints became involved,

he prescribed Prexige. Then when that got taken off the market as people had

liver failure (requiring transplants or causing deaths) he prescribed Mobic.

Then he started me on sulfasalazine. I gradually increased the dose then

developed the most incredible itching mainly on my face, but then all over.

Absolutely awful. I phoned him and he said stop, had another appointment with

him and he said start again. I took one (instead of the 4 tablets) and woke in

the middle of the night with incredible itching. (What a waste of money for an

appt!!). Another appt, and he said to start with MTX.

Like others I vacillated starting, then finally did. I started on 7.5 mg. I

stayed on this for months, without much improvement. Then much later, he moved

to 10 mg, not much improvement. I didn't have any stomach problems or nausea,

but I did get some face itching a few times, BUT I lowered the dose (on rheumy's

advice) and it went away, so the itching was temporary (and not so awful as for

sulfasalazine).

I changed rheumys then, and my second one said there is no point going up in 2.5

mg doses. So I went to 15 mg, together with the Mobic still. A few months later

I went to 20 mg MTX, but had to stop the Mobic as I had terrible burning in my

esophagus every time I took it. Then my rheumy decided to add Arava (10 mg), the

combo worked really well.

Since then I have stayed on MTX + Arava only, no painkillers (so I am luckier

than most here), and no anti inflammatories. I have lowered MTX a couple of

times to 15 mg when things are going better.

Now the points I wanted to make were:

1. I think anti inflammatories mask the problems in joints. Yes, they cut down

the inflammation, but they don't actually stop the inflammation, just prevent

you feeling the effects. Once I stopped the anti inflammatories, we worked out

the optimal combination of disease modifying drugs.

2. People here often talk about MTX, but you need to consider the right dose for

you before saying it doesnt work. Obviously my first dose of 7.5 mg wasn't

enough for me, and I think I stayed too long on the 7.5 mg, also increasing from

7.5 to 10 didnt make much difference.

Mods: please remove any of my opinions if they're not OK.

Special thank you to (Stay well!!) and Walt for their continued support

here re MTX and Arava.

PS: Is anyone else on the MTX/Arava combo?

keep well

regards

max