Question: how long did it take others to respond to MTX?

Hi friends,
I am writing as a parent of a 25 year old son, diagnosed with PsA summer 2016. He has been on injectable MTX X 3 weeks. Minimal response to the MTX pills. So, wondering if I could hear any cheering success stories of MTX, or stories of how long it took after beginning the injection to be effective for individuals out there in PsA community. This is my first post, thanks in advance.

Welcome to the group maudewilley. Any of these meds, it can take up to a few months to start to see a response. That said, not every med will be effective for everyone. I tried MTX orally for 6 months with no change. Instead, I use leflunomide (Arava) and saw a response within about a month of starting it. It can sometimes take some time to get a combination that works.

Hi maudewilley,

I’ve just started injectible mxt. I was told to it wouldn’t be deemed to be not working until at least 8 weeks possibly 12 weeks.

Others on here say it has worked wonderfully for them too. Brought the inflammation right down and the pain and got them off the sofa and gave them their life back.

Right now I’m also on steroids set to taper off over the next few weeks to see if the mxt is doing anything and then playing with the steroids until the mxt is working or is deemed not be working.

thanks for your thoughts. This is helpful.

I really appreciate these details. Thanks.

It’s gradual, but likely that it will be 8 to 12 weeks before one day you say “Hey wait, that didn’t hurt the way it used to!” You’re not going to wake up one morning feeling fab. Sorry to break that to you. :wink:

Just to add … if it does work well, I think Mtx can also have an incremental effect i.e. I found that pain and stiffness continued to improve over a period of at least a year.

I hope your son is doing okay generally. It’s not an easy diagnosis for anyone to handle, let alone one so young. The more he knows about the potential for significant improvement on PsA meds the the better, I should imagine. Is he up to speed on lifestyle changes that can help too? If he’s someone who already likes exercise then that could be a big plus, even if he’s finding it frustrating not being so able to do the same kind of things he did until recently. If he’d like to join this forum too, we’d really like to ‘meet’ him. But anyways, aren’t mums stars!

Great information, this is all very helpful.

Hi Maude,

Glad you stopped by. It seems like the standard answer to how long is “it depends”. For me I waited about 3-4 months, first on the pills then on the injectable form of MTX before I decided it wasn’t doing anything for me.

While you do have to give it a fair shake, you also have to figure out when enough is enough and when it is right for you to ask for the next step in treatment. And that decision point is different for everyone depending on the seriousness of the disease, whether symptoms are manageable, and most importantly how daily life is affected. The calculus is a very personal one. But trust your (and his) gut. And keep your rheumatologist in the loop. Frequent emails to your doctor with questions or concerns can help the rheumatologist fill in the picture between visits.

Glad you came to ask. ~Jane

Thank you, Jane!

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I gave oral MTX six months. We increased the dose over time. I was nauseated from the first time that I took it. It never got any better for me and I had zero improvement.

I took MTX pills for about 3 months and then switched over to the injectable. I’ve been on it for almost 6 months and I don’t feel like it is doing anything for me. I’ve got a follow up at then end of this month and my dr said if no improvement from last time, he is going to change me to biologics.

Sadly I thew up horribly a year ago on the tablets. wasn’t brave enough to try again until this May but on the injectable instead. Managed OK the first week and was dreadfully ill for 5 days the second week so now they’ve taken me off it.

I was at the hospital today, getting my “instructions” for the MTX. one thing they talked about was that it can cause lung problems - I’d not hear that before, and with lung issues already in the family, it bothers me a bit. Has anyone here had that kind of issue with them?

Lung problems in my family too Darinfan and also with me and no it didn’t appear to do anything as regards that. But I most probably wasn’t on it long enough either.

I have recently started on Methotrexate pills. 4 weeks ago. So far, so good for me. I am about 50% better after the first month. Day to day seems better, but if I push my activity level, I still get some of the same pain and tightening in the tendons around my knees, lower legs and feet. So I am taking it slow, but finally have a little hope!


That’s good news, Steen. How are you doing regarding side effects?

Poo…I spoke to a nurse yesterday and she said the family history shouldn’t make any difference.

I have not noticed any side effects as of yet. My lab came back OK except for a slightly elevated WBC. I think this could be do to a recent round of Steroids. There was some talk of increasing to 8 tablets weekly, but they decided to keep me on 6 instead. Maybe because of the White Blood Cell count.

My white blood count is apparently up as well - and I haven’t started taking the tablets yet. I was told it was most likely due to the steroids as it hadn’t been there before (and I had had a blood test only a couple of months ago).