RA treatment

Hi everyone,

I have been feeling very well since my first steroid injection over a month ago. I have met with my rheumatologist and have decided not to start Methotrexate as I am planning to start trying for a family in 12 - 18 months and didn't want to risk the side effects.

He has recommended I start on Hydroxycholoroquine.

It feels strange to start taking a drug when I actually feel fine (very minor twinges in one knuckle only), however he assures me that the disease is working away in the background despite the steroid managing to control the symptoms for now.

I would love to hear from women with RA who have had children since their diagnosis. How was your pregnancy managed?


12 Replies

  • Hi there I had a baby four years ago I was on methotrexate and I was told to stop taking all medication for three months before trying for a child so it would be a good Idea to find out how long it take before its safe to try. Some of the medications advise six months so its worth looking in to. My pregnancy went very well I felt really good with just one flare up at 28 weeks so I feel I was very lucky as was I to get pregnant soon as I could try we did and were blessed. I feel that this RA works in odd ways I really felt that this last year I have been in remission but my consultant says not as my bloods tell a different story so I can see where your consultant is coming from but in the same breath its good to be free of medication when a child is wanted and while your symptoms are very mild it may be a good I thing to have the baby before starting down the medication root. Have a good chat with your consultant or your RA nurse they will always give good advice. xxx

  • Everybody is different and this forum probably represents the people who are struggling with this disease as many continue a relatively normal life once their condition is controlled by medication and have no need for the forum support. Any effects of this disease are hidden and once the damage has been done to a joint it is not reversible.

    I am seronegative and started around 28 years ago in just one knee which has now progressed to many joints from jaw to toes mainly during the last 6 years and unable to work at the moment.

    Throughout my 4 pregnancies (children are 26, 24, 14 and 12) I was able to mange without any medication and for a good while afterwards and breastfed for up to 9 months except the last one which proved to be more problematic (placenta abruption 7 weeks early and had to have a c-section) but I don't believe related to RD and of course I was older (36) and the disease returned much quicker and had to stop breastfeeding earlier to go back onto medication.

    I was on chloroquine - a predecessor of hydroxychloroquine prior to my first pregnancy and continued to take for the first few months as I was not aware I was expecting (or rather in denial as it was not planned). Between having the 1st and 2nd I never went back on any medication. On Gold between the two groups and nothing between the 3rd and 4th. Of course ideas and medicines have changed since I had my children but I wanted to put my experience as some childbearing age members on here have not had any 'remission' during pregnancy. I did find tiredness more of a factor than normal people.

    Hopefully you have contact with a rheumy nurse as a good relationship with them can be worth a lot as a quick chat on the helpline can be reassuring and they are able to speak to the consultant and arrange changes of medication or appointments as necessary. Farm

  • Hello sorry I am a man

    If you are expecting or going to try, it is important that you contact your GP or RA Nurse, as these medications can and will effect your immune system. Personally I am not a medic so I can only suggest you take a safe route as these treatments can effect the proposed baby, possibly you will need to clear your system for a period determined by your medical team.


  • Hello sorry I am a man

    If you are expecting or going to try, it is important that you contact your GP or RA Nurse, as these medications can and will effect your immune system. Personally I am not a medic so I can only suggest you take a safe route as these treatments can effect the proposed baby, possibly you will need to clear your system for a period determined by your medical team.


  • I love the relief that steroids bring - a long time ago a doctor gave several of his

    patients steroids and the patients suddenly got up and moving without pain and

    stiffness. They declared it to be the standard treatment. It worked well for everyone,

    it seemed. Then as time went on, they saw the side effects of use even for a short time

    meaning one every month or few months for a longer time and decided that it wasn't

    such a good idea.. (loss of calcium, bone death, infections, weight gain, drug induced diabetes, etc) They went back to the drawing board and came up with disease modifying

    drugs (DMARD) just like what you are now taking.. if that didn't do it then they added

    or sometimes substituted a TNF inhibitor.. (like humira, enbrel, etc) The DMARD and TFF

    stop the fire going on down below when painkillers, steroid injections mask the pain

    of the disease..so yes, even though we think that we feel better from steroids and it

    sure does take the swelling down, enables us to move our joints, gives us a little tiny

    zip to do the things that we need to, it's not fixing the problem. = /.

    I like that you are planning ahead and are working with the rheumy to have a healthy

    pregnancy without worries.. I find it very interesting that when pregnancy occurs, the

    symptoms of RA improve vastly and then when the pregnancy ends, the symptoms

    return once again. Mayo Clinic is doing a study on this very thing... I read about it

    last week when I was there. You will have to let us all know.... Good luck with everything.

  • I'm afraid I cannot help you as I am one of the people whose symptoms have appeared since (or because of?) giving birth - pain in hands and feet 6 weeks after c section. So I have been told not to get pregnant again until we get ontop of what's going on, and currently on MTX (which seems to be doing nothing so far, either positive or negative, after 11 weeks on it).

    But I do have a question, if you don't mind. What does your rheumy mean when he says that the disease is working away in the background notwithstanding how well you feel. How does he know? Is it that your inflammatory markers like ESR and CRP are still high? If not, what else tells him that the disease is still active? The simple presence of RH factor and/or anti CCP (which I thought could be present without active disease activity). I'm still trying to get my head around this condition.

  • Hi Cornishrex, I haven't had any more blood tests since 1 month ago ( I hadn't heard of ESR and CRP so clearly I've a bit more self-educating to do!). When I say the disease is working in the background I'm paraphrasing him into my own words. He did say that it has been known that with new patients a dose of steroids can knock the body into remission but he doesn't think that is the case with me as I still have minor twinges in my finger joint.

    I hope that helps and the you get some relief from your symptoms soon.

  • Sineaderoo and Cornishrex,

    I have no insight on the pregnancy aspect of your question, but I have same questions as Cornishrex. I have minor symptoms and have had steroid injections with great success. My anti-ccp is strong positive, but my inflamation markers are perfectly normal. Doctor put me on hydroxychloroquine. It is difficult to comprehend taking meds when I feel fine. I too am under impression that the reading of RH factor and Anti- ccp do not indicate activity level of the disease. My first doctor made some comment to me that 'something was revving up' because my anti-ccp reading increased. This goes against all that I read. Like Cornishrex, I am very confused. Can someone help us understand this?


  • It does go against the grain to take these medication when you feel and probably look fine. Looking back I know I would be in a much worse condition joint wise without having taken the DMARD's and biologics that I have had over the last 28 years. Not everybody's disease will progress in the same way - in a way mine had been slowly rumbling along but over the last few years seems to have picked up a few gears whilst others will be hit like a steamroller from the onset of the disease. I am now in a position where my left knee joint has been damaged by the disease and inflammation to such a degree that at 48 years old I am booked in for a knee replacement in March. Once damage is done to a joint is cannot be reversed so the current regime appears to be to treat fairly aggressive with drugs early on. Farm

  • Onslow has echoed my point precisely. I've had CRP levels of 0.4 ish since the day after a single steroid injection 3 months ago. But I soldier on with the MTX.

    I understand what farm is saying. But my understanding is that RA waxes and wanes, and when it is waxing, it is in "active disease state". Which is what the rheumy seems to be telling sineaderoo she has. But what exactly is telling him that it is in active disease state, if she feels fine. Surely not the mere presence of anti CCP / RF, which apparently can be present in the blood up to 15 years before clinical presentation of the disease. Sineaderoo, do you have high inflammatory markers?

  • Seventy-nine patients with RA (62% female; mean age at onset of symptoms 51 years) were included. A median of 13 samples (range 1-51) per patient were available; the earliest samples had been collected a median of 7.5 years (range 0.1-14.5) before the onset of symptoms.


  • Hi everyone, thanks so much for your responses.

    I am not sure about my inflammatory markers so I will have to ask about that when I go to see the Rheumatology nurse in a couple of weeks.

    The Rheumatologist did say that the approach is to treat aggressively and early, the goal being that no joint deformities will take place.

    I am not planning to get pregnant for about a year from now so I am certainly planning ahead. It is interesting the symptoms go into remission during pregnancy (I wonder if more research in this area could lead to a new treatment?)

    Good luck everyone with your treatment. I'll keep you posted with how I'm doing! xx

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