New diagnosis

[AW600]

I am female and 42 years old. I was diagnosed with RA back in November. I had a steroid injection, it helped, but at a review after 3 weeks it was decided I needed methotrexate. Consultant gave me 6 weeks of Prednisolone to tide me over until the MTX kicks in. I take one naproxen a day too. I am so much better, it’s amazing! My only fear is when I stop the Prednisolone in January, will I go backwards? Am I feeling better because of these steroids or because the MTX is working? I’ve had 4 weeks of MTX now

[vonniesims]

The Methotrexate should have kicked in by Jan. Hope it works as well for you as it did for me

[AW600 in reply to vonniesims]

It seems things have moved on a lot in the way they treat RA in the last 20 years. My Mum was diagnosed in 2003 and she didn’t get MTX for 9 years, they just didn’t dish it out so quickly back then. She’s convinced she wouldn’t suffer like she does now if she had been given it earlier, it’s just not what they did back then

[vonniesims in reply to AW600]

Oh yes, massively. I have moved on over the 25 odd years I have had it. Am still on Methotrexate and have various different drugs added and changed. Now on my second biologic and doing ok.

[Fruitandnutcase]

I take hydroxychloroquine but when I was first diagnosed I was given a three month decreasing course of prednisone - until the hydroxychloroquine kicked it - I could have had an injection but I chose to have pills instead.

Anyway, I instantly felt like Superwoman so it could well be the steroids that have made the difference. Could be the naproxen is helping too, I was prescribed that when I fractured my sacrum. First time worked well then later on I was prescribed a larger dose and it was a disaster for me so I had to stop it altogether but for me the low dose for the short time was very effective.

Enjoy feeling amazing, long may that feeling last.

[Gnarli]

Unfortunately, it's likely to be the steroids that are having such a good effect but they will help you until the MTX starts working for you. I've been on MTX for nearly six years and is serving me well

[AW600 in reply to Gnarli]

Do you also take any anti inflammatories alongside?

[Gnarli in reply to AW600]

I can't take them which is a shame as they work so well for most people. I have an excitable tummy it seems. Co-codamol suits me but, then, we're all different aren't we?

[Sheila_G]

I think it might be a little early for the mxt to have kicked in but it could have. I have taken mxt for 20 years and it has been a wonderful drug for me with great benefits and no side effects. I hope it works the same for you. Happy Christmas.

[wilbertjellyfish]

Steroids are wonderful but enjoy Christmas and then at your next appointment they will likely taper them down. Don't stop them suddenly or you'll be unwell. Hope the mtx sorts it out for you.

The advances in treatment over past 20 years are astonishing.

[AW600 in reply to wilbertjellyfish]

I have had steroids before for something else on a reducing course, so I was wondering if he might put me on 5mg for a bit and then stop. I’m seeing him next week so I will definitely ask this as I wasn’t keen to suddenly stop taking the 10mg either. Thank you 😊

[Deeb1764 in reply to AW600]

ideally they like us off the steroids as give side effects like most drugs. For me I take 5mg a day more when needed my GP Let’s me up and lower when needed as he gets I understand the use and reasons. I don’t do injections just the pill form.

All the medication for RA works very differently so just keep a diary for the start of your medication and RA and the. Can keep track of how you are feeling etc and helps when at next consultation

[wilbertjellyfish in reply to AW600]

10mg is relatively low and you can decrease in 1mg increments if needed. I'm usually on 20 and trying to get it down. Have been on 10 for a while now but taking a bit more because I have pneumonia and it's Christmas. 🙈

[AW600 in reply to wilbertjellyfish]

oh my goodness! Get well soon 🥰

[oldtimer2]

I'm sorry that you have had to join our merry throng, but welcome.

Usually the steroids are gradually reduced if you have been on them for longer than a couple of weeks. That gives your body time to re-adjust as the methotrexate takes over.

It helps to make sure that you are well informed about both your condition and options for treatment - have you seen the pages on the NRAS website? And ask any queries here - there is a lot of experieince between us all - although we can't give medical advice we can give personal experience and support when you need it.

[AW600 in reply to oldtimer2]

Thank you

[nomoreheels]

Hiya AW600, welcome. As others have said the improvement you're feeling will most likely be the prednisolone. When diagnosed I was also prescribed a short course of corticosteroids (deflazacort, more commonly used where I was diagnosed). This was alongside a different DMARD, hydroxychloroquine, & also 2 NSAID's one to take nightly & the other when required. Steroids in this instance are intended to reduce inflammation & pain whilst the DMARD, MTX, takes it time to be fully effective. That is usually around the 12 week mark so I would think by the time you'll be tapering your pred you'll be feeling a marked benefit of MTX so hopefully there should be little difference in improvement, for the good.

I started MTX a year into my seropositive diagnosis, as usual tablets first then a switch to injections in 2010. I was diagnosed 5 years later than your Mum & by that time MTX was considered the gold standard treatment. HCQ was chosen because I had little joint involvement at the time so didn't require quite as much oomph from a DMARD. Nowadays my dose is 17.5 mg ( approx equivalent to 20 mg in tablets) & I take folic acid 6 days just not MTX day. You will have been prescribed them too, & in case it wasn’t explained, they are intended to help ease any side effects you may have. You probably know all this through your Mum's experience of taking it for her RD.

I hope you continue to do well once the pred course is finished but of course if not do let your Rheumy team aware. They probably gave you a helpline number for such instances.

The NRAS site might be helpful at this stage & onwards to familiarise yourself with your treatments, tests & much more nras.org.uk There's a section called Your Stories too, they are really interesting. I hope you find being here helpful too. We're a friendly & diverse lot, all at various stages & treatments which is good because there's always someone who'll relate to you. 😊

[AW600 in reply to nomoreheels]

Thank you, this is so helpful. Yes I’m on 5mg folic acid on a Friday and take 15mg MTX on a Monday at the moment. Also taking 500mg naproxen and omeprazole to help my tummy.

[nomoreheels in reply to AW600]

Good, I'm pleased. I also started on 15mg & one 5 mg folic acid the day after, increased to the day before as well when I had a little hair loss. That settled & with a fresh new cut meaning less styling it was all ok. It does return if I have an increase but, again, not for long. So, you know if you need it there is room for an increase. I'm pleased you've also been prescribed omeprazole. You were probably told but taking the naproxen works best when taken regularly. My Rheumy recommended I took my NSAID, etoricoxib, with my evening meds so it helps with stiffness in the mornings.

[AW600 in reply to nomoreheels]

I have been taking Naproxen since September but reduced from 2x500mg to 1x500mg since I’ve been on the steroids. I take my steroids after breakfast and the naproxen in the evening after dinner. I wanted to try and cut the naproxen out but daren’t try yet, I think I’m rushing! I’m very worried about how I’m going to feel after steroids finish but I know meds can be increased and changed, it’s all going to be a bit trial and error

[Pulfs]

could be the a combination of all the meds but I’ve been on mtx for over 20yrs and it’s still working along side a biological which was introduced about 12 yrs ago . Hope they manage to get you on the right combination of meds to help you . Happy Christmas x

[smilelines]

It is all so experimental and hard to know what is helping and what isn't helping. There are so many grey areas. All you can do is wait to see what happens when you taper off the prednisone. Many people find methotrexate to be amazing though so keep your hopes up.