MTX - The Goal?

Just took my 4th dose fo MTX....and here's a silly question. How do you know if it works ?

Since about Wednesday I *think* my pain has reduced a bit but after spending about an hour with my iPod last night, ouch. My hands, elbows, wrists...ouch. I think it's from sitting still (I was tired) and keeping things in a consistent position. Yep, my knees ache from playing my iPod too.

So.....what I'm really asking is what is the goal - I'm beginning to realize that no pain is probably wishful thinking. We're really just talking about reducing pain to more acceptable levels right ? To have less times of intense activity reducing pain ? No matter what, certain activities or lack of activity is a problem.

Man this sucks.

How does one even know if the dose should be increased, the drug should be changed ? Huh.

I have just taken my 4th dose also, my swelling and pain is mainly in two fingers and one ankle, it seems like the swelling has gone down in the fingers however it is still bad in the morning. My doctor told me to expect 3-4 months on the drug prior to seeing results/relief... Good luck to us!!

Hi Elf,

I'm no expert on MTX, but I have been taking it since late summer and I can tell you what my own experience has been. But it may not be what will happen for you.

After about 3-1/2 months on MTX, like you, I thought maybe this is working a little. My toes weren't hurting anymore and I seemed to have less pain in my lower back and SI joints. Also, as you suggested, I had set my expectations really high and was probably unrealistic about what the drug could do for me. So, while I didn't experience a sudden total remission, I thought I could see some improvement. When I saw my rheumy, though, she was absolutely delighted. She said my swelling and inflammation had been greatly reduced and when I told her about my pain levels, she was satisfied that the MTX was doing its job.

While it hasn't been dramatic, I do think it's working, and, for that reason my current plan is to stay on it. My hope is that even though it isn't producing a total remission, maybe it is preventing further complications. That, in itself, probably would be a miracle! Best of luck with it, and I hope it works great for you!

Good question, how do you know if it is working? I went on MTX in September, and by Christmas I had decided that it simply wasn't working. But then I started second-guessing myself, wondering if I had talked myself into negativity, wondering whether my pain levels were, in fact, better than they would have been without MTX ... etc etc. I had an appointment with the rheumy, and wasn't even sure what I was going to tell her when she asked. So I went for my appointment, and she started by checking all my joints. Then she pronounced, "Well, the MTX hasn't helped at all, has it?" I didn't even have to tell her: she has her ways of knowing! She made me laugh!

That's when she put me on triple therapy, which is a whole other thread! I will say, however, that sulfasalazine has given me the nastiest taste in my mouth, and the plaquenil has made me confident that malaria won't be a problem. Other than that, no news yet.