Methotrexate vs Arava | Arthritis Information

 

Lynn49 -- Thank you for all the research you do and for the information you pass on to us!  In your research, have you ever seen anything that compares side effects of Methotrexate and Arava when added to a Biologic? 

actually Arava is harder on the liver than MTX.  Most of the testing for the biologics have been done with MTX which is the gold standard first line disease modifier.   They are probably equally hard on the hair depending on the person.  I take Imuran with Remicade. RD was hoping to put me on arava or MTX, but then after I told her what they do to me, she decided to put me on Imuran. Imuran is much higher risk, and the last resort, but it has been doing well for me, when I do get Remicade infusion. Sharon, just going strictly by anecdotal evidence on the forum, it seems Arava works well for a few people but for most there are a lot of side effects (including me).  Like joonie, I am on Imuran now and tolerating it fine.  I'm not aware of it being a higher risk, but I don't really know.That is what my RD told me. She really did not want to put me on Imuran, but that was all I had not taken. Which it does work well for me, better than the others. I have taken both MTX and Arava (currently on Arava).  I had more side effects with MTX including a chronic candida infection (mouth) that eventually caused me to stop the med.  I didn't have any hair loss issues with either med.  I'm not sure how well the Arava is working since I also take Humira which seems to be doing most of the work to keep this disease under control (not perfectly and not all the time). Arava worked much better for me than methotrexate, but arava was hard on my liver. Mtx didn't effect my liver at all. Both drugs made my hair fall out! I just stopped mtx because of hair loss and have switched from remicade to orencia hoping I can take it alone.Buckeye..Thanks for responding.  It's not that the Methotrexate isn't working.  But my doctor has said (I've read on the board too) that Mtx can increase the risk of nodules.   I had a couple before I starting taking it.  I don't believe Arava has this risk.  Think I'll stick with the Mtx., with the hope that I can do without either drug if the Orencia works well.  Seems like we are always trading one evil for another....but at least there are a lot of choices out there now. Jodi_girl... Thanks for responding.  Sounds like you and I are both thinking along the same line.  I switched from Enbrel and Mtx to Orencia, hoping I can do the Orencia alone.  Did you simply stop the Mtx or did you taper off? SharonThanks to everyone who took the time to reply.  It is great to hear from others who are making the same types of decisions daily dealing with RA. Sharon,

Lynn49,

Sorry I have taken so long to see and answer your question! I stopped mtx all at once with no problem. Hair loss began slowing in about 3 weeks. i just had my first orencia infusion last week and feel like I've taken a step back. My hands and wrists have been very tender when I do the simplist tasks. Maybe it takes the full loading dose to work. My Rd had just increased my remicade dose from 200 mg to 300 mg. My second infusion of that dose, I felt pretty good, so I'm not sure what to think!   I know remicade plus arava works the best of anything I've tried unless the orencia kicks in. I wish I could tolerate arava better!
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