Hi. I would like to ask if anyone takes biologicals without methotrexate. I am on Yuflyma and Methotrexate injections but the methotrexate floors me. Over the years the side affects have now got to a point where I dread taking it. Also recently I have now been feeling unwell for longer. I recently had a blood test as I'm on meds for blood pressure. My serum alkaline phosphate level is at131 U/L which is considered high. GP has yet to contact me to discuss this. I am worried the methotrexate is damaging my liver. I would like to stop but worried I won't be able to take biological without it. Are there any biological treatments to take without methotrexate?
Biologicals and Methotrexate : Hi. I would like to ask... - NRAS
Biologicals and Methotrexate
Written by
Mich1701
To view profiles and participate in discussions please or .
Read more about...
20 Replies
•
Hi. I'm on Benepali only. Was also on ssz but that was taken away when I had to have meds for ulcerative colitis that clashed. This happened back in 2016!
I take AZA with Etanercept which has never given me any side effects and works well despite being one of the older medications.
Yes I’m on Rtx infusions without MTX.
TheMTX had just stopped working for me over night, so rheumy wanted to add Rtx,
I asked WHY?
MTX wasn’t causing side effects, it just wasn’t working any more so why chance it messing up the Rtx?,
He agreed & I have had Rtx infusions without MTX very successfully now since 2016.
Do ask to speak to your Consultant & see if he will think it suitable to stop the MTX, or even just lower the dose if a Biologic is introduced?
Good Luck, I hope you get something successfully sorted out.
I could not get on with methotrexate and take benepali only. Have been taking it for 2 years and doing well on it. We are all different . The only way to tell is trial and error.
Apparently (in the UK) you have to have tried 2 DMARDS before they will consider you for a biologic. After 3 years I could no longer tolerate Mtx. Currently on sulfasalazine and sarilumab - though my RA had to get very bad before I got the sarilumab. Out of the biologics I previously had adalimumab and Rtx (probably because they're cheaper). It's all trial and error as there appears to be no method of determining beforehand which drug is likely to work.
I was on benepali without methotrexate but with enteric coated sulphazalazine worked for me for a lot of years. Methotrexate damaged my liver so can't have it ever again
benpali
I've been on all the DMARDS which all gave me terrible side affects except Sulfasalazine which I still take. But was also put on Benepali over a year ago.
I take leflunomide (and sulphasalazine) along side my biologic. My consultant said that the leflunomide would do a similar job to the methotrexate.
yes I have Abatacept infusion once a month,along with pregabalin,sulfasalazine,hydroxychloriquine,and prednisolone.I did try methotrexate at the start but it stated damaging my liver
I can't tolerate methotrexate (DMARDs nearly killed me) and have been on a biologic (Cimzia) for three years. Also no steroids necessary
I have infusions 6 monthly without MTX .for last 3 years. I had MTX ( supplemented occasionally with other DMARDS and biologicals) for 10 years - had increasing side effects - since being on RTX I realise that the MTX had never really worked.
Have been much better since, though left with some joint damage
Yes I’ve been on tocilizumab for 7 years and always taken it without methotrexate or any other drug alongside. My consultant said he chose toc because it was a biologic that could be taken without methotrexate as I had to give up taking the methotrexate as I couldn’t tolerate it.
Hi Mich, for various reasons I was off all my RA medications and am now restarting after being on prednisolone for 7 months. I'm weaning off the prednisolone and go back onto a biologic anti-TNF without MTX for a trial period. I might have to go back on MTX as well of the biologic on its own is not enough. So yes, it's possible to be on just a biologic. I hope you find a solution.
I tried methotrexate twice when I was first diagnosed but couldn’t tolerate it. My liver function went through the roof so my consultant put me on a biologic and I’m on the third one now (Kevzara) which is working really well and put me in remission zone.
Hi, I am in this situation. Mtx always floored me for a day or two, past year this got worse to the point of always having some level of nausea and being floored for 5 days.I've had a good chat with my rheumatologist and she told me this can happen over time with mtx (I've been on it for 20 years) so she was absolutely supportive about stopping it. I am now in the process of waiting for my new biologic. She gave me 3 options that she felt would be suitable for me and gave me a steroid shot to tide me over.
So to answer your question yes there are biologic options without the mtx.
Hope your rheumatologist and team are as supportive as mine have been.
Yes I’m on Abatacept without Methotrexate. I was on Methotrexate for 15 years along side Sulphasalazine, Leflunomide & Hydroxychloroquine individually not all at the same time. I had 2 years on Etanercept plus Methotrexate but then had to swap to Adalimumab plus Methotrexate. That worked really well for about 10 years & then I developed Pustular Psoriasis of my finger nails. They eventually decided it was due to Adalimumab but not healing due to Methotrexate. They stopped the Methotrexate & it healed so Methotrexate was permanently stopped. That was 8 years ago. I had Rituximab & now taking Abatacept on its own for past 4 years.
Hi Mich1701 I'm on Etanercept Benepali and I came off Metotrexate years ago. Like you I have had RA for 16 years and have high blood pressure. I still have Hydroxychloroquine but am coming off it. Co-codamol 30/500 keeps the RA stable, but it took a while to get to this point, and it took years for the biological to work.
Good luck!
The idea is to keep taking a DMARD (Disease Modifying Antiarthritis Drug) to reduce the chances of the biologic treatment from becoming ineffective. It doesn't matter which DMARD although methotrexate is regarded as the 'best' one. I'm on azathioprine as I had problems with all the others.
Yes I’m on Tocilizumab without MTX. I developed pulmonitis on MTX and it was stopped by my Rheumatologist who then put me on my first biologic.
