I agree with everything TJ says, including the tactical approach if on step therapy. Many of us here in the UK think along similar lines in order to proceed as quickly as possible towards biologics, even though our system is completely different.
I would say that Methotrexate has a better success rate than Sulfasalazine. I’ve been taking Mtx for 7 years, with just one year off. I don’t have any side effects, seriously - none.
So for 7 years I’ve had regular blood tests - liver, kidneys, neutrophils and all that. At one point my liver enzymes were raised which is why I stopped Mtx for a while. However a liver scan showed a healthy organ, so back I went onto Mtx with a slightly higher dose of Folic Acid and all has been well since. So many blood tests over the years - and on the whole, all good.
I’ve always been prone to hangovers from alcohol, though have persevered bravely! Yet PsA drugs rarely cause me any problems. Sulfasalazine was okay … no squitters, no side effects at all, it just didn’t help the PsA.
I don’t like taking drugs. I thought I’d be in some sort of twilight zone once I started PsA meds but as it happened I came out of the shadows and started to feel increasingly healthy for the first time in years. I hope things go well for you too.