DMARDs for Arthritis Q & A

My questions are regarding a 48 yr. old male patient that was diagnosed with rheumatoid on Feb. 6, 2004 (with a rheumatoid factor of 300+). His current medications are: -Prednisone 5mg daily (began Feb. 6th) -Minocycline 100mg (antibiotic)every 12 hr. for fighting the acne caused by the prednisone and in aiding the treatment of rheumatoid (began April 5th) -Methotrexate 20 mg once a week (began March 19th) -Folic Acid 4mg daily -Tramadol HCL 50mg for pain as needed Is methotrexate known to cause nausea (an hour after taking it and lasting for 24 hr. with or without food)? The weekly treatment was recently changed from taking all 8 tablets at one time to taking 4 tablets in the morning and 4 tablets in the evening in an effort to reduce the nausea yet the result is the same. There is the possibility that the methotrexate will be replaced with another medication because of the nausea. Are there other medications (proven to be equally successful in fighting rheumatoid) with less severe side effects than damage to the liver or kidneys that the methotrexate may cause? Every 8 weeks tests are performed to learn of any damage. And is it general practice not to test the rheumaoid factor as treatment progresses (or more than once).

I have spondyloarthritis and need the latest treatment recommendtions. At the present time, the pain is in the left neck and 24 hour headaches.

I am a 34yr old dental hygienist who has been having joint pain and stiffness in both wrists, hand/finger joints and toe joints for about 4 mos. Sometimes the pain is excrutiating. There is also pain and stiffness in my knees, hips, and shoulders.Stiffness persists 1-2 hours in the am and returns during the day after any period of prolonged inactivity. I have been reluctant to try any medications for fear of side effects to my liver etc. However, WILL DELAYING MEDICAL TREATMENT AND TRYING ALTERNATIVE THERAPIES (ACCCUPUNCTURE, DIET, MASSAGE) ULTIMATELY MAKE MY CONDITION WORSE? IS THERE A WINDOW WHERE TREATMENT IS MOST EFFECTIVE MEDICALLY? AM I PERMANENTLY DAMAGING MYSELF BY WAITING?

Approximately six months ago I was diagnosed with RA. In March I had my first appointment with a Rheumatologist who has done an excellent job of explaining RA to me and her treatment plan. At that time my wrists were extremely painful, and several nodules were present. I was running a low grade fever and was exhausted all the time. I also had some pain in my shoulders, and pain and stiffness in my hips made walking a chore. I am currently taking two 750mg Relafen tabs a day, 5mg Prednisone a day, five 2.5mg Methotrexate once a week, and one 1 mg Folic Acid a day. Initially I was taking only four Methotrexate tabs but my Rheumatologist tweaked it upwards to the current five tabs. So far I am tolerating the Methotrexate very well. My hips and shoulders have improved considerably, but the wrists remain very painful, particularly when I first get up in the morning, and for several hours thereafter. For a while, the nodules disappeared, but now another nodule has appeared in my right wrist. It is as if my wrists are stuck in neutral. Am I expecting too much too soon for improvement in my wrists, or is it common to have to tweak the Methotrexate from time to time to obtain optimal results?

I have had As for 6 years and recently have been in terrible pain after a car accident jerked my neck and back which has aggravated condition further. I have asked about anti- tnf medication after reading reports of remarkable results in AS. My rheumatologist has only ever given me nsaids because he said other drugs do not work on the spine. Anti-tnf seems to work on spine! However I have now been offered pamidronate infusions do you have any feedback from anyone who has tried this medication, and if it was effective! They have told me it is run into vein for one hour but the info I have says it should be given slowly over 4-6 hours. I would appreciate any advice you can give as I have first infusion wed 23rd june. From my research anti- tnf sound more effective – but I am prepared to give this a try as long as it is appropriate!

Will methotrexate and Prednisone cure Rheumatoid Arthritis?