Methotrexate not working?

[Lau212]

Hi all,

Diagnosed with psoriatic arthritis in March, have been on Methotrexate for about 9 weeks and it’s really not helping with pain and the bloods still coming back with 30+ on CRP and ESR. I had a steroid injection as I couldn’t cope with the pain and I felt “normal” no swelling or joint pain for a week. Inflammation Bloods went down that week but once that wore off they went right back up.

Also getting high neutrophil count, anemia and High total white blood cells this normal with arthritis?

I have swelling / pain In one ankle, one knee and one finger. I have also developed severe jaw / neck pain I can hardly open my mouth to eat.

Ive has no xrays or any type of scan to confirm arthritis, it’s all been done on blood work. Could it actually not be arthritis but something else??? As I do not have psoriasis!

I’m 32 with 2 kids under 5 and returning back from maternity leave this week!

Any advice welcome.

Thank you!

[Happyrosie]

I’m not sure anyone on the forum could help other than in very general terms as we’re not clinicians able to interpret tests.

But I wonder why you’ve been diagnosed with psoriatic arthritis of you have no psoriasis???

My daughter has psoriatic arthropathy and is going through various types of medication (with no benefit for the skin problem).

There are many different types of arthritis. Have you browsed the website of Arthritis Now? It might give you some clues.

If your ESR is raised I think it shows some kind of inflammatory arthritis.

I’m not sure whether my musings help you at all but I do wish you well.

[Lau212 in reply to Happyrosie]

Thank you, it’s good to hear everyone else’s views. Thank you for replying.

[GracieOS]

Hi, give the methotrexate more time. It takes a while to work. I was diagnosed with rheumatoid arthritis at your age, following pregnancy. Im 57 now. Ive been through long periods where the arthritis has been well managed, even gone into remission, and periods where it has flared up. Methotrexate kept my arthritis under control for long periods. I've since been moved onto biologics, so there other drug options if methotrexate doesn't work for you.

[Lau212 in reply to GracieOS]

Thank you glad to hear it stays under control. Thanks for taking the time to reply.

[Hidden in reply to GracieOS]

I have been changed to Methotrexate injections along with anti-inflammatory tablets. Now told it looks like I have arthritis in my spine. Have a look at Versus Arthritis.

Hope you start feeling better soon.

[Hidden]

My Husband has psoriatic arthritis and was prescribed methotrexate, then each time he went for an appointment his dose was increased then when he'd reached the maximum they could give him and it still wasn't working they prescribes sulphasalizine as well and finally it started working.

You may have to stick with it for a time before they figure out what works.

[Lau212 in reply to Hidden]

Thank you for replying! And for the advice.

[Tikaneko]

Hi Lau212, I too was diagnosed with PA and do not have psoriasis, but my sister has so did my father and both my children have although theirs isn’t to severe. My rheumatologist said that it doesn’t always follow through and has based my diagnosis on symptoms and history. I get painful swollen ankles, fingers and wrists and I also get pain in the jaw. But please read what Arthritis sites and replies on here as there is a lot of much needed support. Take care hope all goes well.

[Lau212 in reply to Tikaneko]

Thank you, hoping the methotrexate kicks in soon is so painful. Thank you for sharing your background.

[Suncntry]

Hi, Lau212, I know it's been a couple of months for this post, so hope it's not too late to chime in. I have psoriatic arthritis and have had psoriasis most of my adult life, but my psoriasis disappeared about 12 years ago. It took almost 6 months before the methotrexate started working, and they upped the dose a couple of times during the process. It started working just short of 6 months when I was taking 8 tabs a week (20mg). My rheumy lowered the dose to 6 tabs (15mg) recently due to elevated liver enzymes, and it's "managed", but still have some bad days here and there.

My brother also has PsA and psoriasis and takes humira, which works very well for him. Unfortunately, I'm not able to take biologics for other reasons at this time, or I would try them too.

I'm sorry to hear you have this disease, and it can be different for everyone. So the best thing is to talk to your rheumatologist about it, and work with them to adjust or change medications as needed. I truly hope you get some relief soon and can get it under control quickly.

[Lau212 in reply to Suncntry]

Thank you so much for replying, I’m now on 10 tablets of methotrexate a week, 1 leflunomide a day and had another 6 weeks in prednisolone . I have felt amazing the last 6 weeks but now as I’ve nearly finished the steroids my ankles have swollen right back up. Just hoping it doesn’t get any worse than this.

My rheumatologist still hasn’t done any X-rays etc so have no idea how bad it is. I paid to see the chiropractor as my neck and jaw were so bad before these 6 weeks and he did a jaw/ neck X-ray and confirmed I have no curve in my neck and it’s straight and said it was arthritis.

Glad to here you and your brothers is managed and you only have a few bad days.

Thanks again for the info and replying, so great hearing other peoples journey.