Question
Hello,I hope you can help me make a difficult decision. I am currently on the 4th NSAID to try and treat inflammation of my joints. My doctor said he thinks we should try MTX since NSAIDS aren’t working. I am diagnosed with lupus and besides joint inflammation, I feel pretty good. I am not taking any plaquenil and was given the option before but rejected it. I told my doctor I wanted to research a bit before I gave an answer. Do you think I should try the Plaquenil first before starting MTX or is it fine to jump to MTX? From what I read so far, seems like methotrexate is a bigger drug with more side effects so plaquenil would be the better choice. Any information would be helpful.
Answer
Both drugs are well tolerated and useful in patients with lupus associated arthritis. Its difficult to comment directly on your situation. In general, most rheumatologists (including myself) use Plaquenil before MTX for lupus arthritis.
