Long term efficacy of methotrexate? | Arthritis Information

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Hi,

Sorry in advance for the long post - this is my first post here.  A brief history is that I was diagnosed with an undetermined form of autoimmune arthritis in April 2007.  Both my grandmother and mother have RA, but test negative for rheumatoid factor.  I have several other autoimmune conditions, some of which can also cause arthritis (psoriasis and crohn's). 

I've been taking (oral) methotrexate since diagnosis with mixed success.  When I first started taking it I had surprisingly good success on a low dose.  At various points I started getting some breakthrough pain and upped the dose.  I'm currently at 17.5 mgs. 

The last few weeks I've been having a fair amount of joint pain and I'm thinking it's time to go back to the doctor.  Part of me is hesitating because the pain seems largely connected to the weather; but the other part of me is saying that since my other autoimmune conditions are flaring the methotrexate isn't working (one of the flaring conditions has no connection to weather) . 

Part of my hesitation is because I've more than tripled my original dose in the last year.  I'm reluctant to go higher because last time I tried 20 mgs I had some side effects.  It seems strange that the medications appears to be losing its efficacy so quickly.  Has anyone else had noticed a similar decline in efficacy?

Thanks in advance,
Melissa

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