How Long Does Arava Take To Work?

[Pat64]

Good Morning All, I started 10 mg of Arava/Leflunomide nearly 2 months ago now, alongside Sulfasalazine which I have been taking for 3 years but which never fully controlled my RA. Although my inflammatory markers have now come down to within the normal range, my wrists are still swollen and I don't as yet have full use of my hands. I would like to know if anyone who is on Arava has found that it can take longer to work and if there is still a chance I may see more improvements as the weeks go on. Many thanks.

[Alison-NRAS]

Hi pat, normally Dmards can take between 3 and 12 weeks to notice an effect and up to 6 months to feel the full effect. It is a good sign that you your inflammatory markers have lowered hopefully it will not be too long before your symptoms start to reduce as well.

[Pat64 in reply to Alison-NRAS]

Hi, Many thanks for your advice. Much appreciated.

[medway-lady]

4 months to really get going, so from 2 months I noticed a real difference then every day a bit of an improvement. All swelling and pain then had gone and normal life resumed. But really one day I woke up and knew I felt great compared to the previous few months so be patient.

[Karen77]

I just started 2 weeks ago. I think the literature says 6-8 weeks but my rheumy told me yesterday at my appointment that it could take 4 months.

To compare, some people feel improvement on methotrexate (MTX) in just a few weeks. I took it for 6 months, feeling worse every day (more pain, less mobile, more joints affected, etc) and saw no improvement until I started Humira. So I thought the MTX was doing nothing but poisoning me, and reduced it over nearly a year until I stopped it altogether. Enter a year-long flare that only subsided when I was back on MTX. When I stopped MTX again in March of this year due to persistently high ALT/AST readings, I started to flare again. So, I guess it *did* do something. It just took forever, and I am not patient.

Honestly, when you're flaring, each day seems an eternity so the idea of waiting half a year (or more) to know if a drug is working seems unacceptable. In the grand scheme of things, a year may not be long. But I am also anxious to not sit around and get worse with the faint hope that I'll eventually get better sitting around and waiting for the drug to "maybe" work.

One thing that is interesting, is that my rheumy said yesterday that only like 5% of RA patients get better on a DMARD alone (i.e. MTX, sulfasalazine, plaquenil, Arava). And only like 15-20% get better with a biologic (i.e. Humira, Enbrel). It makes me feel grateful every time I can climb the stairs without wondering if I can or when I can run up the hill to meet my kids as they get off the bus (these are not always possible!).

Good luck. I hope Arava works for you (and for me!)

[Pat64 in reply to Karen77]

Hi, I too am very impatient at the thought of waiting around for up to 6 months, with no guarantee that the drug will work. I assume that you are still taking Humira and now Arava and I know that the Rheumatologists always think that combination therapy can be much more effective. Unfortunately, I have only been on one dmard for 3 years and I do have some joint damage so I am hoping that adding in Arava will help reduce the pain and swelling. Fingers crossed and counting! Hope you don't have to wait too long.

[Karen77 in reply to Pat64]

I know how you feel. But hey, after 6 months of taking MTX alone with NO improvement, I thought it wasn't doing anything for me. It was only after I had been on it for 2 years and then tried to stop that I realized I was better off WITH it. I was not patient either. And I certainly don't want to poison myself daily with no obvious improvement. But that's probably also why my rheumy only wants to see me every 6 months. I presume they get a lot of whining/complaining... (I try to save my pent up importent rage for this Forum, lol, because I don't want to discourage anyone from becoming a rheumatologist - we need more of 'em!)

[Seashoreshanty]

Started arava last friday so i am hoping to see improvement. I am really suffering at the moment knees hips wrists are on fire with alot of pain, i also think i have the flu starting as blocked nose and an awful headache! I am taking paracetamol and just got some sinutab.. wondered what pain relief tablets you take?

[Pat64 in reply to Seashoreshanty]

Hi, When pain becomes unbearable, I find that paracetamol and co-codamol just aren't strong enough. I have taken Naproxen - 250mg twice daily and that takes the edge of the pain and allows me to function. On doctor's advice though, I only take it for a few days until things settle down as it can cause stomach problems. I hope you find some relief soon.

[Karen77 in reply to Pat64]

I've been taking Meloxicam for pain. It doesn't seem to bother my stomach and I often take it on an empty stomach so I'm certainly not doing my tum any favours.

[Seashoreshanty]

Thanks for replies. Will check these drUgs out with the doc.