Question
I have newly diagnosed RA with high RF and Citrulline antibodies. My Sjogrens Disease ( 8 yrs duration- dry eyes, dry sensitive skin and mucous membranes, peripheral neuropathy ) is further complicated by multiple pollen and chemical allergies. Arava 10mg/ da, aggravates my Sjogrens symptoms with urticaria, angioedema, plus skin rashes. I am also taking 3.5 mg Prednisone/ da and would like to stop because of fluid retention. What other DMARDS would be better or combination thereof.
Answer
See our section on RA treatment. Methotrexate remains the first choice of DMARDs, initally as a single agent but also in combination with TNF drugs (Enbrel, Humira, Remicade) in patients who do not respond to methotrexate alone. Triple therapy with methotrexate, Plaquenil and sulfasalazine has also been used.
