Hi there. I have had RA for six years. I have been on 4 different demands and am currently on leflumonide and hydroxy. I had a joint injection into my shoulder yesterday which showed up a lot of erosion and a tear in the tendons all caused by the RA. My rhumy then said that at my next review (next week) we would need to review my Meds. The problem is I don't think I'm going to meet the DAS score for biologics as my bloods have always been fairly level yet there is a lot of damage going on. Anyone any ideas where I might go from here? Thanks.