Methotrexate : Methotrexate- has any one else noticed a... - NRAS

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Methotrexate

Oneta profile image
15 Replies

Methotrexate- has any one else noticed a rapid increase in deformed joints since taking methotrexate, six months in and I am noticing my joints are becoming deformed at a rapid rate, is this a side efffect of the drug or am I just getting osteoarthritis at a rapid rate.

Thanks in advance

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Oneta profile image
Oneta
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15 Replies
Simba1992 profile image
Simba1992

Hello Oneta, Sounds more to me that the mtx isn't working as it should. You talked about cutting down your dose recently. Did you have a talk about it with your doc? What dose are you on at the present?

Oneta profile image
Oneta in reply to Simba1992

15mg weekly

oldtimer profile image
oldtimer

The methotrexate should be protecting you from erosions. Perhaps you need to review your treatment?

Oneta profile image
Oneta in reply to oldtimer

Thanks for your prompt reply, cheers

helixhelix profile image
helixhelix

Talk to your rheum team as sounds like your treatment plan might need tweaking. The only times I've picked up erosions has been when I reduced drugs....

Oneta profile image
Oneta in reply to helixhelix

Will discuss it with my doctor on my next visit, I like to do lots of research and get a bit informed before I approach a doctor as I feel a bit rushed in a surgery

nomoreheels profile image
nomoreheels

Hiya Oneta. As MTX is prescribed to help stop joint deformity in the form (very concisely) of reducing the inflammation that causes them to become damaged then no, you shouldn't be noticing any. As long as your dose is correct & your blood tests & examinations (DAS 28 score) show you're controlled then all should be well other than the most common issues such as fatigue.

As it isn't I wonder if you also have OA. MTX will do nothing for OA progression... it would be helpful to know which joints are being so noticeably affected. I have both RD & OA, recently halted my NSAID & my distal interphalangeal (DIP) joints nearest the nail & trapeziometacarpal (basilar joint) at the base of the thumb/wrist are very quickly being affected. I have heberden's nodes on fingers that were spared until halting my NSAID, my thumb, index finger & little fingers had them but now all my fingers are affected. The intention was to wait until my next appointment to review restarting my NSAID but it's clear something has to be done before then, mid Sept.

Don't know if any of this helps or sounds familiar?

Oneta profile image
Oneta in reply to nomoreheels

Sounds a bit like me; I must agree as I reckon it is OA in my joints, I suppose what surprise is how quickly the joint deforminity is appearing. Six months ago there was nothing now it is progressing rapidly and I wonder why the rapid progression.

BoneyC profile image
BoneyC

Unfortunately MTX at best can only slow down joint damage. I've taken MTX for nearly 40 years but most of my joints are damaged.

Oneta profile image
Oneta in reply to BoneyC

All I can say is bugger!

Hello Oneta I saw a Rhematologist last September. I was referred to him with ?Sjogren's Syndrome. He took one loook at my hands & told me I had RA. I developed a rheumatoid nodule about a year or so ago & asked the junior doctor about it. She just waffled! I looked at the NRAS website

nras.org.uk/rheumatoid-nodules

I found this passage interesting [from my point of view] but it may go some way to answering your question

There is a suggestion that the incidence of rheumatoid nodules is falling (possibly due to the reducing severity of rheumatoid arthritis) but nowadays they are most commonly seen in patients commenced on methotrexate therapy in whom the nodules that develop tend to be small and multiple (micro nodules) most commonly around the finger joints. About 8% of patients on methotrexate develop micro-nodules and we don’t really know why. The image with this article shows a severe case of rheumatoid nodules. Micro-nodules are normally slightly smaller, at around 0.5cm across.

in reply to

I should have said I took MTX for 2 years & stopped in 2014. I am taking Pred & have been on that non stop since 2011 or 12, I forget now

RA isn't my main problem, it's a bonus!

Oneta profile image
Oneta in reply to

Read the article definitely not nodules like that, hence I am thinking it may be OA

Maggsie profile image
Maggsie

Oneta, are you using your joints more because you are generally better when taking Mtx? You do still have to protect those joints even though they're feeling OK. I've had damaged joints over the years even though on Mtx but I'm rubbish at protecting them. When I feel well I just get on a do stuff and b..... the consequences.

Oneta profile image
Oneta

How do you protect your joints, I just get on with living, then I notice a red ring around my joints and deformed.

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