Doc tells me that I must add something like Arava or Humira to my current 25mg per week injection of Methotrexate.
Generally I have been doing pretty good except that when I try reducing the perdnisone from 5 mg per day, down to 4 mg I get a flare in my hands and wrists within 3 or 4 days.
I could probably live with the flare, as I taper, but the flare causes swelling in my wrist which then causes horrible carpel tunnel pain.
I have had several skin cancers removed over the last several years which is listed as a potential problem with Humira but Arava, of course, can cause problems also.
My Doc has explained the issues involved with each med and has ask me to select the one to try. I have reviewed many of the internet sites but cannot come to a decision. however because of the cancer issue I am leaning toward adding Arava to a reduced methotrexate dosage.
However, to muddle my mind even more, I have looked at sites that indicate that 5 mg or less of prednasone long term could be acceptable. Maybe I should add nothing extra? (After about 15 months since I was diagnosed, I have had no perceived joint damage.).
I would be most grateful for any thoughts on my problem.
I'm not sure I can be of much help. I started with MTX which worked pretty well but eventually caused a recurring thrush (candida) infection so I switched to Humira which is also working very well. My doctor has told me that she would recommend adding Arava to the Humira if I needed more, but so far the Humira alone is working fine. So, obviously I'm somewhat biased towards what I know which is the MTX and Humira. Do your xrays show any signs of progressive joint damage...the pred could be hiding the symptoms but not preventing the damage, a possible reason to not just leave things as they are.
AlanThanks for the useful info Alan. So far the xrays have shown no joint damage. Have you experienced any damage?
Fairly minor erosions in the first year, but no progression since taking MTX and now Humira...so far so good!
I have took both Humira and Arava. I would pick Humira over Arava for myself any day, even with me having reoccuring bladder infections due from having IC.
Maybe try getting off the pred, even if you flare would be a good idea. I am a long term pred user, have been on pred for going on 4 years now, and only been off for a month. Boy was that month horrid
Maybe if you do not feel like adding anything maybe one of our board members that does alternative treatments can give you some ideas.I have not taken Humira, but I take enbrel, MTX and Arava. The enbrel was added when the other meds didn't. I take them all right now. The only drugs that I have noticed a difference is enbrel and prednisone.
Joonie, what don't you like about Arava? My RD suggested it as a possibility for me, as I have been flareing every 2-3 weeks these past two months. Arava would be in addition to MTX and Enbrel. I passed, just because I'm wary of adding another drug to my list. I'd like to keep the number low, ya know?
Ketch~ as you can see, I have no infor for you on Arava or Humera, I'm really interested in what you decide and how it works for you. Please keep us posted.My dr. started me on enbrel injections (couldn't tolerate the mxt). When my knees started to hurt, he added the Arava but since I am sensitive to some meds, he started me at 1/2 the recommended dose. That way he said it gives us room to play if he has to increase it to the full dose. Well surprise surprise - I am fine on the 1/2 dose! I'm now on 1 injection of Enbrel a week and a 10mg pill of Arava daily.
Tough decision to make. The only thing I really caution you about is the long term pred use without using a biologic or DMARD. It is kind of like putting a band aid on the whole situation instead of treating the actual condition that causes the RA in the first place.
The lymphomas are very rare altho we are in a higher category of contracting skin cancer than most people. That doesn't mean that it will happen.
Either med would be acceptable to add to your weekly dose of mtx. I guess I would base my decision on which med has the best results in working with the mtx.
Link, I did not like how it made my hair fall out and how it made me have to go to sleep every night at 6pm and tired throughout the day. It was like non-stop fatigue, and it also made me have very very bad memory problems. I forgot my moms phone number that at the time I dialed 5-15+ times a day, and I could not remember.
Yeah... no Arava for me EVER!
But I am sure Arava only effects crazy, nutty, loons like myself.... so if you are not one of those... I am sure taking Arava will work wonders for you