I am taking 15mg of methotrexate a week. I will increase that to 20mg in a couple weeks.I am also taking 15mg a day of prednisone. My dr has not explained any of my results from blood work or fluid results yet, I assume he will do that when I go back to see him in March. I was wondering if the meds I am taking are more than usual or a standard amount given to all new patients. I'm just not sure of the extent of my disease. I guess based on the meds Im taking, I want to know how bad my PA is. Thanks if you can answer
I think I started on 15 mg of methotrexate, orally, in the beginning and your dose of prednisone seems similar or less than what I took after my first visit with the rheumatologist.
I continue to take 5mg of prednisone which is a very low dose. I take 20 mg of methotrexate in the injectible form. For me, it works better and has less gastro side effects.
The meds do sound pretty standard. But I'm not sure you can second guess how bad your disease is based on the meds you start off on as rheumys vary in their approach. My own view is that this combination sounds like quite a good starting point regardless of severity. Hopefully the prednisone will give you some relief while waiting for Methotrexate to start working.
I had severe disease at the point of diagnosis but I've responded well to drugs overall. A lot of us here do have severe problems and / or disease that just won't let up. Those whose PsA quietens down quickly probably aren't that well represented on online forums as they're unlikely to feel the need for ongoing support and info. Just mentioning that because you may well be one of the luckiest ones, I hope so!
And of course PsA is very variable too. So much depends on how well you respond to treatment. You could perhaps ask your rheumy a bit more about how he or she is thinking, for example do they think you have any sign of joint damage? And you could also ask about the results ahead of your appointment. But invariably there's a big 'wait and see' factor.
Thanks, I do know that I have bone deterioration in my foot and the dr said it is systemic and that I have had this for many years. Was always diagnosed with plantar fasciitus until I switched foot drs and the new one did an mri. I have frequent fluid on my knee and pain in my back. I am in my 5th week of meds and still feeling pain in my back and knee, foot is ok. I have been able to work without wearing my foot brace, so thats good.
I'm no expert but the fact that your doctor actually said that you've had PsA for many years sounds good to me. Not that it's good in itself, just that a doctor who shares that with a patient would inspire my trust. So many of us have had to work these things out for ourselves. I'm making assumptions but I wouldn't mind betting that a doctor who recognises long-standing disease will be thinking in terms of biologic therapy down the line.
I hate the phrase 'patient journey' because I usually like journeys, just not this one. But oh boy it is a journey. There are so many of us here who can testify that the early days are often by far the worst. You have to get through them being really hopeful and doing everything you can to help yourself as well. Great to hear that you're experiencing some improvement but it's tough I know.
Cookie said:
Thanks, I do know that I have bone deterioration in my foot and the dr said it is systemic and that I have had this for many years. Was always diagnosed with plantar fasciitus until I switched foot drs and the new one did an mri. I have frequent fluid on my knee and pain in my back. I am in my 5th week of meds and still feeling pain in my back and knee, foot is ok. I have been able to work without wearing my foot brace, so thats good.
Cookie, Sybil is right again, it's a not-so-fun journey, but there will be better times. Especially since your doctor seems very understanding and knowledgeable-just that he did the MRI on your foot/feet provided him with better information about them that the other doctor didn't figure out.
I was such a doubter, not wanting to start a biologic because my negative voice kept saying it wouldn't work anyway so why bother getting all excited about the possibility of feeling better? I was so wrong and was I the happiest girl in the whole USA when Enbrel made my life so much better. And I stuck around here because the people are great and there are so many interesting discussions going on. Also, if your feet are damaged (mine are, too) you might want to stick around for more support/advice even after the meds/biologic lessen your PsA symptoms.
Cookie, there are no blood tests to either diagnose or judge how serious your PsA is. You’re just going to have to ask. As Sybil says, every rheum has their own protocol for treatment, so the drugs and dosages don’t tell you much either. What you’re on sounds like standard starter treatment to me.
However … (you knew there was going to be a “but”, didn’t you?)… if you already have some damage, your rheumatologist may be more inclined to pick up the pace of treatment. If it were me, I’d welcome that. The latest research is showing that patients who get early and aggressive treatment do best in the long run.
Let us knowhow this goes for you!