Questions, questions. questions!

[Smithycat]

When my RA was diagnosed in 2016 I was prescribed Sulphasalazine. This did not improve my symptoms so my Consultant added Methotrexate. When this didn’t work my Dr stopped the Sulphasalazine and I just took Methotrexate. This was ineffective so finally a biologic, Imraldi was added. I was very hopeful but unfortunately although I have now been taking both drugs since the end of January I have still not had any improvement. I am concerned because:

A) presumably this means that my joints continue to be incur damage.

B) Taking both of these drugs together the risk scoring guide for Covid-19 (nras.org.uk/data/files/COVI... puts me at higher risk, which isn’t good if I am not getting any benefit.

A friend of mine is taking Sulphasalazine and Benepali (biologic) for RA and is in complete remission. The combination of these two drugs puts my friend in a lower risk group than myself.

My question is, does anyone know if Sulphasalazine Would work as a substitute for Methotrexate to be taken alongside my Imraldi? Do I need to give the drugs more time to work? Otherwise, What have other people done when their first biologic hasn’t worked?

My goal is to get an improvement of my RA symptoms and also if possible to lower my Covid-Risk.

I would be very grateful for any advice or comments.

Thanks 😀

[allanah]

Absolutely one to discuss with rheumatology. Mine are still taking phone calls and giving advice and treatment that way. I would suspect if it's the same as my pathway they would consider changing your biologic as you already take one .

I wouldnt change any meds without chatting to them first xxxxx

[Smithycat in reply to allanah]

Absolutely, I have an appointment with my Rheumatology Nurse on Thursday I was just wondering about other people’s experiences and any suggestions of questions to ask her. I was concerned that I won’t be able to have a different biologic, not sure how this works. And also people’s experience with combination therapy. Thanks and thanks to Lolabridge too😀

[allanah in reply to Smithycat]

I have had 4 different biologics over the years !

[Lolabridge]

Totally agree with allanah that you must get advice from Rheumy. We are all so individual that what works for one may not work for another.

[Brikel]

I take Sulfasalazine and have Benepali injections weekly I have been on this combination for approx over 2 years . It definitely works for me as I have been mostly pain free for that time.

Hope this helps

Brian

[Smithycat in reply to Brikel]

Thanks for the reply. I am sure that the nurse will want me to persevere but I would rather be on than Methotrexate because it lowers my risk for Covid. Thanks again 😀

[Kind_of_blue]

I was diagnosed with RA in August 2018. After an allergic reaction to Methotrexate I was prescribed Sulfasalazine and Hydroxychloroquine was added two months later. I started Imraldi in October 2019 but at my review four months later there was very little improvement. The consultant was going to switch me to Benepali but suggested I persist for just a little longer on Imraldi as some people can take longer to respond. I was finding the Imraldi pen difficult to use and the "sting" quite uncomfortable so was switched to amgevita (same active ingredient of Adalimumab) and after six long months really turned a corner. I'm not sure if this really answers your question but just wanted to share my experience that it took six months for me to respond to my first biologic. I truly hope you get some relief from your symptoms soon x

[Smithycat in reply to Kind_of_blue]

Thanks for your reply. I suspect that at my appointment the nurse will say that I haven’t given the Imraldi long enough and to persevere. It’s just really frustrating not feeling any better but having the anxiety of being vulnerable to Covid. Thanks again 😀