All of these meds (other than steroids) take a while to work. I started off on plaquenil and am still on it, 5 years post diagnosis. I had to have another DMARD added in, but everytime that I'm having a lot of disease activity I think back to what things were like before I started it. EXTREME fatigue and pain. So while I still get fatigued, it is a much lesser version typically. Have you had improvement in your those two areas, while not necessarily making things perfect?