Decided to give Methotrexate another go

Saw my rheumatologist on thursday as current meds (lefluomide, hydroxy) not working too well. Been pondering about starting enbrel after being given the go ahead a couple of weeks ago. Anyway, make your mind up time arrived on thursday and I decided not to go ahead with enbrel. Instead my rheumatologist decided to put me back on mtx, which I was previously taking to good effect for 9 years. Latest recipe... 10mg lefluomide, 10mg mtx and 300mg hydroxy. To cut a long story short, mtx was stopped by a different rheumatologist a year or so ago because I developed a bladder condition and was hospitalised with a stubborn UTI, and was put on lefluomide after I recovered. One of the reasons that swayed me away from enbrel was apparently, my urologist would not commit himself either way if it was wise for me to start taking an antiTNF drug... I'm concerned about the higher cancer risk even though my rheumatologist is, perhaps more sensibly, more concerned about the risks from my recurring UTIs. She said there's no proven cancer link with enbrel after 15 years of use.

Must say this was a very difficult decision for me and still I still have serious doubts that I've made the right choice, time will tell I suppose. One good thing is that if current meds don't work out I still have the option of starting enbrel without going through the long painful process of being reassessed.

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  • Hi wishbone,

    I do hope that the methotrexate and your latest " recipe" (!) will work well for you. Do remember though that it can be a while ( 3 -12 weeks) before you may notice any benefit from the methotrexate.

    I am not sure whether you have seen our article about Enbrel so I have put a link here for you. It also covers the cancer risk you mention in your post:

    nras.org.uk/etanercept-enbrel-

    Kind Regards

    Sally

  • Thanks very much Sally,

    After reading the info it has swayed me little more in the direction that I made the right decision about not starting enbrel. I think one of the reasons my rheumatologist wanted me to go on it was that it exits the body relatively quickly should I get an UTI. Trouble is I don't always get symptoms 'til the darned things get a grip... God I wish I was 30 again!... :) :) :)

    Had my first methotrexate tab on saturday, and yes I do remember that it can take time to work, so I could be in for an uncomfortable few weeks. Think it was around 6 - 8 weeks before I felt any benefit when I started taking it 10 years ago and possibly double that for full effect. Can't have a steroid injection if needed either as I had one about 6 weeks back. Can anyone tell me the minimum length of time between injections?

  • Hi wishbone,

    My pleasure, glad you found it helpful :-)

    Regarding the minimum length of time between steroid injections, unfortunately there is no hard and fast rule. There are different types of steroid injections - short acting and long acting as well as different strengths. So it would be a question really to ask your rheumatology team as they would be taking into consideration your particular case, treatment you are already on etc. etc. It is worth bearing in mind too, that steroid injections vary from person to person and injection to injection. Some people may get great relief from a steroid injection only to find the next time they have one it doesn't seem to work so well and there is then obvious disappointment when it doesn't have the same effect. On the other hand some people find they work well for them on each occasion.

    I have put a link here to steroid injections for you:

    arthritisresearchuk.org/art...

    Take care

    Sally

  • Hi Sally,

    I've had several steroid injections over the years. All appear to have been the quick acting type and have worked fine so far.

    Thanks again

  • I have been on enbrel now for over 4 years and thave never looked back, my hands were so painful before I started, along with knees,feet,and hip but the hands were worse.now its unusal for me to have that much pain and no stiffness at all. I understsnd its not for everyone but I'm glad I was given it.

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