Can you help me with a few queries please

[JulieR2]

I have moved to methotrexate 15mg injections following diagnosis of psoriatic arthritis in February this year. I started in July as I was struggling on the oral medication and was not improving. I was give a shot of steriod IM whilst the methotrexate started to work! This was like a miracle. I was able to stop the 800mg of brufen I was taking twice a day and was pain free.

I haven’t had to return to taking brufen but my knee is still very swollen and stiff and my shoulders are still stiff. Will this go? Or am I expecting too much?

Also I can’t remember whether I am supposed to stop methotrexate before or after the covid booster? Any ideas

Thanks in anticipation 😀

[oldtimer]

This doesn't seem a very good response so far after three months on 15mg. You should get back to your rheumy team with the query - they might increase the dose or add in something else.

[JulieR2 in reply to oldtimer]

Thanks for the reply I have an appointment on the 18th of October so I can discuss then I hope. It’s a telephone consultation so goodness knows how they assess😀 I wanted to check if I was being realistic I guess I am better but not without my problems😃

[Boxerlady in reply to JulieR2]

I had Methotrexate dose increases after telephone consultations with rheumy nurses last summer - they reported back to the consultant who then prescribed the new dose. When that didn't produce enough improvement, I was called in for a f2f assessment (again with a nurse) and a new medication was added.

You need to (politely) say that you're still having problems and ask if they can do something to improve things. I was inclined to underestimate my issues because I was aware that I was doing better than others but after encouragement from the lovely folks on here, I pushed for changes and I'm really glad that I did as my joints are now good - I don't take any pain medication and apart from some early morning stiffness and the old twinge I've got no real issues. 😊

[Sarmita50 in reply to Boxerlady]

What medication was addef sfter f2f review? I have got dimilar problems but am not improving. Good to know that you feel better now.

[Boxerlady in reply to Sarmita50]

I was on Hydroxychloroquine and Methotrexate and Sulfasalazine was added so I'm on "triple therapy". I had gone up to 25mg Methotrexate by injection but the Sulfasalazine seemed to be the missing piece of the puzzle for me so I've now dropped back to 20mg.

Obviously everyone is different but I found the phone consultations fine although it felt odd to be assessing my joints myself.

[helixhelix]

At nearly three months you should be starting to see a result. So push your medical team as 15mg of MTX alone may not be enough for you.

I was advised to stop my MTX for my vaccinations (flu and covid) as I am very stable so no risk of a flare. It sounds like you are no where near stable, so would be a very different matter. Ask your medical team.

[Boxerlady in reply to helixhelix]

Can I ask how long you were advised to stop MTX for please? I'm stable on triple therapy atm so definitely want to miss a MXT injection or two 💉😊

[helixhelix in reply to Boxerlady]

You really need to take advice from your own team…..we shouldn’t be giving medical advice!

(But I stopped a week before & after, just MTX not Embrel)