What to do about meds.....current regime not helping!

Hello all...I am new to this board so I am hoping I can get some useful advice from people who are going through this horrible experience as well. I was diagnosed with Psoriatic Arthritis with spondylosis in January of this year, after having been misdiagnosed as having Osteoarthritis in 2008. (suffering since then!!!) The new Rheumy that I saw in November of 2011 (the one that finally diagnosed me in January of this year) put me on Sulfasalazine and NSAIDS for the pain, and I am supposed to come back in three months. So far, I can't take the NSAIDS as they are causing me stomach problems, even with a stomach "protector", and the Sulfasalazine is doing nothing.....I actually am getting alot WORSE!!!!

I have one other complicating factor with my condition in that I had 3 spinal operations in 2002, 2003 and 2006 for a spinal fusion L4 to S1 with instrumentation. The first 2 surgeries failed and the 3rd one "took", however it created alot of scar tissue and nerve damage, so I am on a pretty hefty pain management program for that back issue anyway...MS Contin on a 2 x daily basis...you would think with that I wouldn't have so much pain, but that doesn't really work for the arthritic pain. I have NO skin issues (Rheumy said that sometimes that can show up later?) but have acute pain in my fingers, sacrum, spine, neck, hips and toes...and have the dreaded sausage fingers....so gross!

I don't know what to do with the meds situation...I am in so much pain and feel that with the first misdiagnosis that I have been waiting so long I know I probably need to give the Sulfasalazine a chance to work, but I have heard that Enbrel has had success for this disease (hey it worked for Phil Mikkelson!).

Has anyone had any experience with Sulfasalazine? How long did it take to work...did it work at all???? Any advice would be appreciated....sorry for all the rambling....just don't know what to do.

You probably need to get on a biologic such as Enbrel or Humira. See if you can get on one quickly to prevent joint damage.

I was diagnosed at the beginning of Feb. and started Sulfasalazine and Celebrex as my regime. At the time I was told that I would see improvment in 3 weeks but after 4 weeks now I am still pretty bad (walking with a cane and sausage fingers). I read on the companies website that it takes 6-8 weeks to see any results. Unfortunately I can't offer any good advice as I'm in the same situation as you. I'm just hanging in there.

I was on sulfasalazine for three months. It didn't work for me, but it is the drug with the least side effects so my rheumy wanted to give it a fair chance. From what i've read it doesn't work very well for PsA. I would say if you've had absolutely no improvement after a few weeks to call your rheumy and see if you can start something else.

Thanks Emma, that is good to know. I guess I will try to move my 3 month appointment with my Rheumy up from the end of April to the end of March...if I don't have anything happening by then with the Sulfasalazine, I will definitely ask her to try one of the biologics like Enbrel or something....did you finally get something that worked for you?

Emma W said:

I was on sulfasalazine for three months. It didn't work for me, but it is the drug with the least side effects so my rheumy wanted to give it a fair chance. From what i've read it doesn't work very well for PsA. I would say if you've had absolutely no improvement after a few weeks to call your rheumy and see if you can start something else.

Well, I tried to move up my Rheumy appointment from April 23 and they said they have NO time available to see me prior to my scheduled appointment!!! AARGHHH!!! They offered to put me on the cancellation list in case anyone cancelled and I can usually make it on short notice, but gee....I guess I am going to have to continue to feel this crappy, and hopefully not continue to get worse while this sulfasalizine apparently does nothing!!!! Thanks for your help everyone...I think I need to push my doc to be on a biologic if and when I ever get in to see her. This disease is horrible...but I guess I don't have to tell all of you that!!! (and I don't even have the skin issue part of it!)

I hated Sulfasalazine. I wasn't on it for more than 3 weeks before the side effects got to me. Keep looking, don't take no for an answer!

Have you tried Nexium with your NSAID? I have to take 40mg with mine to prevent ulcers. Full stomach helps too!

I don't have the skin stuff either. Check your family... My dad was diagnosed with Psoriasis shortly after I got the PsA diagnosis.

I've been on mtx for a month now and it hasn't worked yet :/ but I need to give it three months before the rheumys here will put me on a biologic. I hope you can find something that works for you soon :)

Is it working yet. hydroxychloquine isn't working for me and the Rheumatologist wants to put me on sulfasalazine next. I'm not sure I can face another 3 months on something else that doesn't work!

Hi Gwynneth....No, I have been on the Sulfasalazine now for 8 weeks and it has done nothing, in fact I am getting worse. No REALLY awful side effects though, other than a bit of nausea at the beginning (went away over time) and it makes me quite "gassy" if you know what I mean. I have had new joints start to swell while on the drug, and have had to increase my pain meds, so all in all, I would say that Sulfasalazine has done nothing for me. I definitely will be pushing for something like Enbrel as I know my benefits will pay for it at my April 23 appointment. Good luck to you.