After 9 months on Methotrexate and 2 months on Sulfasalazine, I still cannot go without a daily dose of Celebrex (celecoxib). After 3 days of being off of the Celebrex, pain, deep joint aches and fatigue hit like a brick. It makes me wonder if the DMARDS are doing anything at all. Adding the Sulfasalazine hasn’t really helped but no noticeable side affects. Could I be one more step towards a biologic? Are most biologics safer over time than Celebrex?
I’m on a biologic but still fairly useless without daily Tramadol and a daily anti-inflammatory - Arcoxia. However I am significantly improved on the biologic even just 4 weeks in. My aim is hopefully to lose those altogether hopefully by the 6 month mark assuming this biologic works for me - the previous two didn’t, one took an age to get going as in 6 months and then stopped working at 3 months and the other never worked at all.
How many sulfasalazine tablets on you on? 4 a day or 6 day. It did nothing for me until I hit 6 tablets a day - 3,000mg. Also sulfasalazine would have difficulty really working within 2 months. It takes at least 3 to 6 months for most people. And given you’re only on mxt for 9 months (what dose?) my guess it’s a bit early yet to think you can do without any other pain relief.
Are biologics safer over time than Celebrex? I doubt it. Both are fairly safe unless you develop either of their side effects. Reading the list of the immediate and long term side effects of any biologic is not for the faint hearted that’s for sure.
Hang in there @Amos!
2011 - 2014 I spent my time a) getting worse followed by b) being disabled then c) less disabled but still with swollen joints and unable to walk without help of some type. 2012 - 2014 was spent on DMARDs which ushered in c).
2014 marked a return to being well and active a lot of the time and that was when I started Humira. Maybe I was having a long flare-up that would have calmed down eventually, but all I know for sure is that getting my life back corresponded with starting biologics. You can see why I endorse biologics … how could I do otherwise? Nothing awful has happened to me yet.
I’m currently on 25 mg MTX/week and 2000 mg Sulfasalazine/day. Thanks for the encouragement to keep waiting. I’ve been doing 5 days on Celebrex and then 3-4 without…thinking that my liver and kidneys could use the break and sort of detox. My pharmacist didn’t think there was any harm and possibly some wisdom in letting them “clean out”. But I could be really off on my approach. It does cause huge swings in feeling ok and then really bad. I add 1000mg of Tylenol to the mix when really miserable or have to go out and pretend I’m ok.
I’m just waiting for someone to tell me that when I hit 60 in March, all the symptoms disappear!
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Talk to your rheumy at the 3 month mark about the possibility of upping the sulfasalazine to 3,000mgs if you still feel it isn’t doing much for you. I didn’t take mxt with it but it did nothing for me until I hit 3,000mg per day and within a week it all switched on like magic and I certainly knew it was working. Sadly it all switched off just a quick around 7 months later.
Personally I’d be evening out the swings of feeling OK and then rubbish. That’s quite exhausting surely?
Sadly I haven’t had @Sybil’s longevity with one biologic yet. I remain ever hopeful though. Certainly this far on mumber 3 at 4 weeks I’m already seeing significant improvement. But I’m not off either the painkillers or anti-inflammatories yet.I lose those when I realise I’m forgetting to take them because I obviously don’t need them. That’s usually my trigger. That’s not happening yet. However I am able to lose the paracetemol taken with the tramadol to increase its effectiveness. So I’m on my way. This far at any rate.
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Thing is, Celebrex and biologics are completely different drugs. I think you know that actually … but even so, it really isn’t ‘either / or’.
The comparison needs to be between traditional DMARDs and biologics. If you still have significant joint issues on trad. DMARDs, then biologics should be the next step. Biologics are not painkillers. However anything that calms the disease process down over time can be, effectively, a killer of pain.
Yep - at 60 one becomes like a teenager again. Also, Brexit isn’t happening and I’m gonna win the lottery this week. (I love your optimism!)
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HaHa! Thanks…I guess we have an obligation to tell the world that at 60 everything is pain free! Keeping ones sense of humour in all this muddle of the meds is helpful. You did help clarify things for me as I was thinking that once on biologics, if they work, I won’t need the support of nsaids etc. So, “Into the great unknown”, an adventure, right? “But I don’t like adventures, they tend to make one late for dinner”. I digress. Has anyone found some of the foot massage machines beneficial? Rubbing my feet ‘til my hands get angry brings some relief but could massage be aggravating the enthesis hot spots? I don’t have visible deformation of my feet but the pain causes cramps…which cause more pain. It eases off once up and moving but after sitting or trying to sleep, the pain/cramps are terrible. Are the foot massage units (the ones you put your foot into) beneficial?
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No idea but I’d give it a go. Does over-enthusiastic massage aggravate PsA (joints or entheses)? I wouldn’t have thought so, not unless you’re actually hurting your feet. But again I don’t know.
I have had cramps for ages & ages. If I am very good on the alcohol front (as I am these days - gold star please) the cramps ease. Good disease control sorted out the craziest, hopping-around-screaming cramps and the type that last all bl**dy night.
Why haven’t you tried a biologic yet? You don’t seem averse to the idea … It’s too late for me to stop being repetitive, but I think of PsA as having side effects - uncontrolled inflammation can cause a lot of nasty ‘stuff’ in addition to the main disease.
I’m still over a month away from the next scheduled Rheumy appointment. She said, “Its not easy to get you on biologics, its lots of paper work and we first have to eliminate the possibility of DMARDS working for you”. I guess that I will eventually end up on biologics but need to complete what the system requires. I have no idea as to when that might happen. I assume that you are merely using the alcohol as a topical ointment. 
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@Amos and @Sybil - you guys are making me giggle. I’m 58 in January - do you think I’ll get this almost age 60’s rush of pain free stuff and just plain positive stuff then? It’s certainly not presently in my thoughts. However I’ve no idea why I’m soon to be 58 - in my head I’m around 30 and sticking! It feels like a pretty positive place to be stuck in though, so I’m OK with that.
@Amos Canada’s biologic protocol is similar to the UK’s isn’t it? No funding on biologics till DMARDs have failed you? Hence your delay in comparison to the USA norm of putting people quickly on biologics.
Foot/leg cramps. I’ve also no idea if those foot massage spa things work. They sound nice though. What does help for foot/leg cramps though is magnesium. Best way to get that is from Epsom bath salts which of course you could put in the foot massage spa thing. Or alternatively just put some in a basin and soak you feet in it of an evening. Or simply put it in a bath and have a long soak. You can also get a magnesium spray from most drug stores or health stores which can work too. Tonic water helps too - probably best without any gin. Gin in my view is a depressive. Wine on the other hand is not. And I’m not on mxt, don’t forget.
And very interestingly putting a dry bar of scented cheap supermarket soap in your bed can also help. That’s an old wives’ tale but it can amazingly work. But just as cheap and cheerful though is good old Epsom bath salts, which tends to work better in my view.
As my disease has gone on - oddly the foot/leg cramps stopped being quite the pain in the proverbial as they were initially. I’ve no idea why. They do return when a med fails though. Presently they’re almost non-existent. So I guess Consentyx is really starting to work. The rest of my body agrees with that too.
Quit though overly worrying about the Celebrex for now. I’ll let you know when I’ve quit the Tramadol and Arcoxia. I’ve been on Arcoxia since at least January and added in Tramadol again when my first biologic failed in March and since then I’ve been through another biologic which never worked (merely caused rotten side effects) and both are now still is propping up my 3rd biologic which I’ve only been on 4 weeks so far.
60 is very strange. For example, if you have gin, or indeed, a lot of wine, on your 60th birthday you are indeed rejuvenated. For about 10 minutes. But after that you start to feel more like 160 and remarkably unwell to boot. I don’t understand it.
And it gets worse. I’m now 63 and the rejuvenation and zest for life lasts for a mere 5 minutes after imbibing more than a little alcohol and then I start to wish I was dead. Cheers everyone!
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I think I got more done on Celebrex, on a new biologic Cimzia that just started working, but without tramadol daily, I would be a wreck. Pain doctor even approved 10 Norco for breakthrough pain, mainly with my back. I have yet to battle it out with the pharmacist, who will now regard me as a street person… 
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