It's time to move on from sulfasalazine but to what? Do I add MTX, try Enbrel or what? Is there any source that's good about comparing the pros and cons of all the meds out there? I can research each one individually but it gets so confusing. I'd love to find a somewhat objective, definitive source...Sulfasalazine and another DMARD work well together. They sort of jump start one another. Why start a biologic if you haven't taken other DMARDS? MTX will be easier for you to take and have less side effects than a biologic. I've been on MXT for several years with NO problems related to it's use. The literature is starting to show that the best effects come from simultaneous DMARD use. These are things you need to talk over with your RD. Do a spread sheet for the DMARDS showing side effects, how well it works, etc. Take the spread sheet to your next RD appt. and go over each of the DMARDs.
Look at the 2008 recommendations here: http://www.rheumatology.org/publications/guidelines/index.asp