Hey, fellow sufferers. So, I’ve always had scalp psoriasis and maybe 10 years ago I developed it mildly on my face, mainly on top of my eyes and earlobes, what looks like scaly flaky skin. My recently diagnosed PsA has been progressing so rapidly in the last year, and went from just one elbow and both knees to basically all my joints, with my lower back and hands being the worst. Oh and the bottom of my feet feels terrible, but I guess that’s the enthesitis.
Anyways, I started the methotrexate on a low dose 10 mg 6 weeks ago. I feel no change, I know it could take up to 6 months AND it’s a low dose that can be increased, but I still feel like the PsA progressing.
For example, a couple of weeks ago I started noticing guttate psoriasis patches, that started on my hips of all places. It’s still mild, but every other day I discover a new small patch.
Also, my fingers keep getting worse and now my thumbs are involved to the extent that they sometimes very briefly lock up.
The flaky psoriasis is now around my eyes, not juse on top. My eyes are starting to burn and feel really dry.
Any thoughts abut what may be going on?
My thinking is that the methotrexate should at least stop the progression long before it can affect the pain and such to where it’s noticeable. Am I wrong in this assumption?
Any input appreciated.
There are doubts amongst PsA experts as to whether Methotrexate is disease modifying. The authors of ‘Psoriatic Arthritis, the Facts’, who include Dafna Gladman from the Toronto Clinic, state that it’s used so widely around the world mainly because PsA patients report that it helps. However they do say that it may prevent disease progression, but it seems the jury’s out on this one.
I found that it reduced swelling a bit and eased up my joints. I also felt a whole lot better little by little. I suppose it took a couple of months to see a difference. So for me I’d say that it seemed to slow down the disease and ease symptoms at the same time. But ultimately it never did enough of either.
Mtx is often used to prop up biologics by preventing our bodies producing antibodies to them (or something like that - I reckon understanding of these mechanisms changes all the time). So it could be useful if you start biologics at some point.
6 weeks could be just a little early to know what, if anything, Mtx can do for you. It is a low dose though and as the ‘trial’ period is so often more like 3 months than 6, perhaps you should ask your rheumy about possibly increasing the dose soon. It’s important to give drugs a fair trial, but maybe not such a good idea to be increasing the dose a few tablets at a time for many months, only to decide eventually it’s not sufficiently effective.
That’s so interesting, Sybil.
I never came across that when I was doing some research about it. It’s certainly worth keeping in mind. I do have an appointment coming up with my rheumatologist and I’m hopeful that we’ll figure this out. I’m just trying to understand as much as I can.
Thank you for your input!