I supposedly have psoriatic arthritis/tendinopathy however there is no evidence in my blood. My tendons attaching to elbows and feet become extremely painful. I was put on MTX 15ml injections for 8 months but stopped as my blood cells were slightly enlarged and the jury is out if it was even working. Rheumy wants me to try again at 20ml injection this time. I'm not keen even though joints are sore and I'm very stiff when trying to get up.
My question : has MTX worked for anyone in this group with psoriatic arthritis?
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Cheylann
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I have this combined with spinal arthritis. I'm afraid nothing much worked for me drugs wise, other than steroids straight into joints and sacroiliac joint. Plus the odd intramuscular steroid shot. That may not be the case for you though. Some people find great relief with different types of drugs. I found exercises, and staying as mobile as possible helps. Plus I changed my diet and took out all the crap I was consuming. Not perfect, but better than I was.
MTX did not agree with me at all, so I wasn't in it long enough to see if would have been helpful or not.
I've also tried a couple of biologics but didn't find either of them particularly effective for me.
I'm currently around 12 weeks into trying a JAK inhibitor, upadacitinib. If you would have asked me 2 weeks ago I would have sworn it was helping as I'd had a good couple of weeks with virtually no tendon pain, something I haven't experienced for what feels like years. Then just under two weeks ago a had a flare out of nowhere. It settled down after a few days, but I seem to have leveled off where I was before seeing the improvements I'd put down to the medication.
I'm trying to remain hopeful that with a bit of time I'll get back to where I was a couple of weeks ago. I'm wondering if tendon inflammation/pain takes time to settle down once an effective meditation has been found. When you think of it in terms of sports injuries, tendon problems seem to give athletes the biggest problems and longest recovery times.
Perhaps it's worth asking your rheumy to discuss all the possible treatment options available to you?
Unfortunately, we have to start this journey with mtx. She will make a case for biologics but only after I've tried mtx at the 20mg dose.I agree, tendon pain takes ages to heal. Problem is mine never does and is always lurking in the background. Can't remember the last time I was pain free. Not a great way to live.
I also have psoriatic arthritis. I have been on Methotrexate 25mg tablets since December 2023 and in March I started taking Leflunomide 10mg every day together with methotrexate. So far I have no improvement and my ankles are swelling and I still have to use a crutch to move around. At the end of July I have an appointment with a rheumatologist and they will probably add a third drug to me, I talked to the nurse and she told me this.
I have it too. I am on a Biologic and Methotrexate. The dose of that was increased from 15 to 20mg when I complained I didnt think the biologic was working. The increase dose has helped
It was the MXT that was increased. I was treated for RA for about 20 years until I had pelvic scan for a different medical problem. It showed inlammation around my lower spine and apparantly that doesn"t happen with RA so they changed the diagnosis.I too am sero negative
I was doing well i thought on Benepali, but I am not so good on Amgevita . I seem to ache all the time particularly knees, and ankles,my toes burn, my fingers are at an angle to my hand and my elbows are so deformed I need one replacing.!
I have an appoitment with the consultant who I haven't seen for 3 years soon to discuss this. I am able to carry on normal living tho' and Paracetamol occasionally manages the disomfort.
The increased Methtrexate dose did make a big difference
My sister is same as you and they just treat it with prednisolone when her symptoms flare up, Her blood test show nothing untoward . She lives in Australia so their system.
I've no idea if it works for your situation sorry, any chance of being able to discuss your situation with the specialist nurse?
Hey Cheylann. I have psoriatic arthritis (and nothing ever shows in my bloods, either). I was originally prescribed sulfasalazine, which made very little difference. Methotrexate was then added, at 20mg. After a couple of months I thought there was a very slight improvement, but nothing to get excited about. Then after about 11 months I quite suddenly felt miles better, and have been good for 2 years now. I rarely have joints that swell and burn for no reason -just pain and swelling after I overdo things (so probably caused by osteoarthritis). I also have loads more energy than before. I can't be certain the meds helped, but sometimes if I've missed meds for any reason, I get a mini flare. So, possibly worth trying the mtx. Good luck, whatever you decide
Yes Cheylann. 20mg methotrexate in tablet form worked for me within 12 weeks, taking me into remission. A few side effects, hair thinning the worst. Good luck on your journey.
I have no experience of MTX injections or psoriatic arthritis however I been taking MtX tablets (7X weekly) for RA for some 6 years now with no problems. I have had to stop them For a few week before and after surgery because they slow down or stop healing .I take them in conjunction with sulfasalazine( 2X2 X 500mg daily) and folic acid (1X5mg weekly)
I have RA and I was put on Methotrexate in the beginning of my treatment but unfortunately ,despite the test before hand,it affected my lungs and I was hospitalized for a week on oxygen. I recovered but came off this and tried lots more drugs which haven’t helped as side effects occur. It is very hit and miss as I know quite a few people on it very successfully. I hope you will be one of these.
I too have Psoriatic arthritis diagnosed after 6 years previously diagnosed with sero - negative RA which doesn’t show in bloods like you. I couldn’t tolerate high dose of MTX so on a maintenance dose (10 mg). Just started my 8th drug hoping this is the one. I would ask for a steroid injection to see if this will give you relief for a short while. It doesn’t look like your medication isn’t fully working. Be proactive ring them if things are bad . No one should suffer. Sometimes you need to be heard or they think you’re ok . Good luck
Hi. I used to be on Nymesulid but it was banned due to side effects in a minority. I have been on 20mg MTX for around 15 years - I take this alongside Voltarol and steroids and these keep my psoriatic and osteo in reasonable order.
I have irregular (maybe every 2 years) injections into worst areas (knees and base of thumb).
It is working so well my consultant wanted to reduce by MTX dose. I declined cos if it is workign - why change.
Hi CheylannI have have Psoriatic Arthritis tried MXT didn't work for me then a whole host of other drugs which all gave me terrible side effects and did not work.
The only thing I have found that works is Apremilast it comes in pill form which does give you some minor side affects bowel and bladder especially in the first few weeks but then it settles.
I do still have some pain but when I had to stop it for a Total knee replacement recently.
I realised how hard it was to cope after stopping it. it's not a hundred percent for me but I will say about 70 percent better than without it at all.
I do have other tablets for other conditions though.
I would definitely give this a try as it is specifically made for Psoriatic Arthritis.
I am under a Rheumatologist and it comes from the hospital.
It's worth a try, as I could not cope with the awful side effects of the other arthritis meds
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