Methotrexate

[Bigal45]

Hi my old rhumy has been in touch surprised I have been given Methotrexate. I have Sero negative inflammatory arthritis with osteoarthritis. Any thoughts would be appreciated. Bigal45@

[Hidden]

For 13 years I was seronegative, and on MTX. Been Sero Positive for 19 years, still on MTX, but also Leflunomide.

[Hidden]

I’m s-negative I’ve been on methotrexate for 4 years started as soon as I was diagnosed worked fab for first 3 years . Take a biologic along side methotrexate still not quite there yet.

[helixhelix]

If you had symptoms that merited being put on MTX then that’ what’s right for you. Sero-negative/sero-positive makes no difference. Perhaps when you had seen this old rheumy it was much earlier in the disease process?

Or is he old-school? As modern approach is to hit it hard and quickly, and then reduce drugs. Not start with an aspirin and wait till joints start being deformed before trying anything else.

[Bigal45 in reply to helixhelix]

He says I have inflammatory arthritis not R.A. So Methotrexate will not help very confused.

[Gnarli in reply to Bigal45]

RA is an inflammatory arthritis. Inflammatory arthritis is an umbrella term for a big family of diseases with lots of nasty, painful and misery-inducing symptoms. I wonder why he contacted you? I think I'd believe my current rheumatologist

[Bigal45 in reply to Gnarli]

Current rheumatologist told me that she see’s a deterioration in joints on X-ray. Original rheumatologist says he does not see deterioration? I think I Got phone call after he saw notes!!!!!

[helixhelix in reply to Bigal45]

Yup, I’m with Gnarli on this one. And even if it is one of the other diseases that come under the general heading of inflammatory arthritis, MTX is commonly used as first line treatment too.

Sounds like you are being bounced around in an internal war between these two docs. It is very bad practice to undercut a colleague, so old rheumy should have spoken to new rheumy rather than you. It is not fair on the patient as it’s not your job to sort out their conflicting advice. Personally if I was in a super-assertive mood I would tell old rheumy that, and to take it up with new rheumy.

[Bigal45 in reply to helixhelix]

Thx for all your reply’s I am on week 7 of methotrexate still hoping for improvement in pain. Will express my concerns to new rheumatologist next week. Thanks once again bigal45

[bubblyalex in reply to Gnarli]

I agree with everyone. Very weird he would say inflammatory arthritis is not RA... it can be and inflammatory arthritis is defo treated in the same way as RA.

So weird that you have two consultants getting involved and very very unhelpful.

[AgedCrone in reply to Bigal45]

If I were you I’d listen to the rheumatologist who is treating you now.

[nomoreheels]

I'm more intrigued why he's concerning himself with your care, unless he's deputising for your current Rheumy? Either way, if your current Rheumy considers it's the best treatment for you he's the one you work with. You have a current diagnosis of seronegative inflammatory arthritis, a systemic condition & yours warrants MTX, it's not an unusual treatment. RD, PsA & AS are also inflammatory arthritides, maybe your Rheumy hasn't arrived at a final diagnosis, perhaps it will turn out you'll be either of the second two considering you're currently seronegative.

I hope it's helping.

[Gnarli]

Oh dear. I reckon Helixhelix and nomoreheels have got it. Two doctors in some sort of professional tussle putting you in the middle. Not fair on you. In your position I'd be listening to my current rheumy. Very poor behaviour from your old rheumy

[Sheila_G]

I don't know why she is surprised. Sounds perfectly normal to me. x

[mjrminor]

I was diagnosed sero negative with inflammatory arthritis 2 and a half years ago and the first thing they did was try methotrexate. Didn't work for me because it triggered my asthma, but anyway....

My rheumy at the time said that he gave me that diagnosis as an umbrella term as he couldn't pinpoint whether I had RA or psoriatic arthritis, but the treatments remain the same. My new rheumy just says I have sero neg RA. I'd definitely go with your current rheumy's thinking.

[Hidden]

I have sero-neg RA and was totally disabled by it for a while. MTX has done wonders for me. I'm within a cat's whisker of my old self. My advice would be to stay on it if it helps you.

Why is your old rheumy getting mixed up in this if you have a new one? The last thing you need is conflicting opinions. If s/he wants to question your current treatment, they should take it up with your current rheumy.

[Bigal45 in reply to Hidden]

Thx for reply 8 weeks in with methotrexate tomorrow, 4 on 15 mg & 4 on 20mg. Inflammation slightly down but no pain relief fingers crossed it kicks in soon!!!

[Hidden in reply to Bigal45]

I was given Prednisolone early on before the MTX started working. I had to do a very slow taper of that, but have been off it for 5 months now. It took quite a while for the MTX to work. 8 weeks is still quite early. It was 4 or 5 months for me, but really good now. If you are not getting enough good effect from it, ask about Prednisolone. You may read scary stuff about that too, but a low dose need not be that bad. Getting off it gradually (for safety) can seem endless, but with this disease it seems it's a long haul with every aspect of treatment.

Best wishes. Let us know how you get on.

[Bigal45 in reply to Hidden]

Will do thx for information.