DMARDs for Arthritis Q & A

For the past 8 years I have been on a weekly dose of 17.5mg of oral Methotrexate and 500mg of Plaquenil( the dose of plaquenil was reduced after 2 years of taking it, when it stopped being effective.) I have had several minor flares all along and taken NSAID .However since the last 6 months my joint flares are frequent and I am on constant anti-inflamatory’s . Please could you tell me if the dose of Methotrexate is increased , will I experience less number of flares? Or has Methotrexate stopped being effective ?I am waiting to get an appointment to see my rhuematologist. I am 52 years old and was diognosed with ‘Poly-arthritis”

Would there be any reason to be on both Remicade and Humira, at the same time?

Thank you for your response to my earlier question, “Effectiveness of increased Methotrexate “.This is a follow up question . The flare ups that I experience are not very severe, in that there is not much redness or much swelling (as experienced when I was first diognosed with the disease).Usually the maximum recommended dose of NSAID for 3 or 4 days and with restricting the movement of the affected joint, either with a brace (as in my wrist)or resting a painful hip, I am able to get back the functioning of the joint.However movement of any joint beyond a certain limit causes it to flare . My question is, if Methotrexate does not work as effectively as before and I am wary of the TNF blockers as well as the phenomenal cost of the treatment , is it safe to continue with using NSAIDs. Also will injecting Methotraxate be more effective than pills?

Thank you for your response to my earlier question, “Effectiveness of increased Methotrexate “.This is a follow up question . The flare ups that I experience are not very severe, in that there is not much redness or much swelling (as experienced when I was first diognosed with the disease).Usually the maximum recommended dose of NSAID for 3 or 4 days and with restricting the movement of the affected joint, either with a brace (as in my wrist)or resting a painful hip, I am able to get back the functioning of the joint.However movement of any joint beyond a certain limit causes it to flare . My question is, if Methotrexate does not work as effectively as before and I am wary of the TNF blockers as well as the phenomenal cost of the treatment , is it safe to continue with using NSAIDs. Also will injecting Methotraxate be more effective than pills?

Hi, Iam planning on getting pregnant. Currently I take 5mg prednisone daily, 25 mg enbrel twice a week, and 15mg Mobic daily. When i do find out that Iam pregnant what and when should i stop the medications. If i continue to stay sore, what medication is the safest to take, and is tylenol safe to take everyday instead of one of the other medications especially the first trimester? and do any of these cause any side effects or birth defects if taken, especially first trimester?

I received an R.A. diagnosis 2 years ago. X-rays of the hands and feet taken at that time showed no erosions. I have been taking 17.5/mg. of methotrexate since that time, and have been feeling quite well. A month ago, I had new X-rays taken. The rheumatologist called with the results. She said there was an erosion in a toe. She commented that the radiologist reported other things, but she said they often “overread” the films. I asked for a copy of the report, and was dismayed to read that the radiologist detected “erosions throughout the hands.” Yesterday I made an appointment to meet with my doctor to discuss the possibility of going on a biological med. Even if the radiologist erred, wouldn’t the erosion in the toe be enough to suggest that the methotrexate alone might not be doing the job? The toe erosion happened silently–no redness, swelling, or pain. I should add that I had a strong positive CCP test result, so I know I’m at risk for more erosions. My questions: Based on the above description, do you think a biological med would be a good choice? Do radiologists frequently overread X-rays? What should a patient do when a rheumatologist and radiologist disagree? Do you have suggestions on how to best communicate with my doctor about trying a biological medicine?