Psoriatic arthritis and treatment

[Nocturne123]

Hi everyone .

I have had psoriatic arthritis for a number of years . It went into remission for both pregnancies and my plan was to try and deal with the pain with pain killers/ anti inflammatories for a year or so before trying for dc3.

The pain has just got so bad recently it would be easier to pinpoint the joints that aren't affected . I can barely walk or move my neck in the mornings which is so hard with the two Dcs .

Does anyone know if methotrexate is the first drug of choice to treat the condition or are there others?

My issue is that I do want dc3 and wanted to avoid methotrexate if I could .

Will be making an appointment with the rheumatologist soon I just wanted some insight first!

Sorry for the whinge .

Thanks in advance

[Nocturne123]

Hopeful bump

[mrspottasbubble]

There are other dmards you can take but mtx does work. I am on mtx and sulphasalazine for mine but the rheumy is doing the hoop jumping to get me on biologics. If it's as bad as you say it is then your only real options are the immuno supressant ones. I inject mine weekly and after 5 months i am starting to see some improvement. If you are on fb then i am in a group specifically for psa in the uk and its a fab group!

[Nocturne123]

Thanks so much , what's the name of the group?

Glad to hear you're seeing some improvement

[mrspottasbubble]

It's 'Psoriatic Arthritis Sufferers UK' There are only 214 members.I joined in August time I think and it's a great little group.Although there is really only a core of us that post and ask a squillion questions.It's certainly made me feel better at times knowing I am not alone.

Re the mtx.Ir really can make you feel very nauseous at the beginning and wipes you out the next day,some not all people.But when I think back to July when I cried everytime I had to move my elbow to now where it's still painful but bearable it's worth it.

[Nocturne123]

I'd read that about methotrexate that it does cause nausea and tiredness, but I guess it's better than pain !

I'll have a look for that group , it really is quite lonely sometimes and I find people really don't understand too well what it's like ( why would they? )

My knee is the main culprit so getting up and down stairs with a baby and toddler in two is a bit of a nightmare .

[mrspottasbubble]

It's one of those awful diseases that keeps a lot hidden.My tendons have been attacked beyond belief so I may look completely normal but inside at times the body screams.

Have a read about mtx but I started on oral but could not cope on an increased dose as I was loosing 4 days a week to nausea,stomach cramps and tiredness.Injectable form is far more tolerable for me,no nausea and just a mild mtx haze.

You may find that you fit the criteria for biologics but you have to fight to get them due to the massive cost so only those in real need get them.

The point of the immunosuppresants is to slow the disease right down to prevent the need for future joint replacements and disability.

[Nocturne123]

Thanks everyone for the info . I'll have a read on the Internet about the various drugs and torture my df some more for some medical opinions.

Then I'll make an appointment ( and stop burying my head in the sand )

Flare ups are the worst .

[MrsStarwars]

I have RA and have been taking mtx for about 18 mths. I have no side effects at all and my joints are much, much improved. Definitely worth a try.

[Hulababy]

I have PA and was dx a few years ago.
Initially I started on Sulfasalzine, along with steroids. However, I now take Methotrextate in addition to these. Though they don't take away all the pain ime - I take CoCodamol (30/500) and Diclofenac as and when required for that.

The Sulfasalzine and Methotrexate are keeping by blood stats stable and down, and helping to prevent any long term joint damage hopefully.

[Hulababy]

I did have a fair bit of nausea and tiredness with the methotrexate initially. My dose is now split over two days and I take folic acid a few times a week too. It has improved. I don't get very much nausea now and when I do it is more short lived. I do get tiredness and lethargy but that is from the PA more than the meds.

[CarcerDun]

Psa here too and sounds like I'm on the same drugs as everyone else. I take mtx by injection and have my dose in the evenings so that I can take advantage of the drowsiness!

I had to come off mtx when ttc, but took sulphazalazine throughout pregnancy and breast feeding.

The Facebook group sounds interesting...

[RandomMess]

My dh only needed to take mtx for 3 months and then the flare up really calmed down and he just has mild residual pain - it's not yet flared up to that level again in about 3 years?

[Nocturne123]

These all sound really positive . Much better than other things I've read on the Internet .

I'll go have a chat with the rheumatologist and see what he thinks I should do in my situation .

Thanks everyone this has calmed me down . Was having a bit of a panic because this recent flare has been one of the worst .

[RandomMess]

My dh was the same but was very pleasantly surprised that although the side affects knackered him for a couple of days the difference was huge and as I said only needed to take them short term. IMHO they are worth trying, it doesn't work for everyone but you can't carry on how you are - something has to change.

Hope it works!!!

[SunshinePickle]

I have PsA but didn't want methotrexate as I was thinking about TTC. Started on sulfasalazine which I was allergic to and now on azathioprine which has helped so much (and is relatively safe in pregnancy unlike methotrexate which is a definite no-no).

They don't consider biologics until you've failed to be managed by a couple of DMARDs. Biologics don't have that much safety data in pregnancy yet, but look okay so far.

[SunshinePickle]

Also forgot to say, although they won't use them forever steroids give amazing relief while you wait for other meds to work. I had monthly IM depomedrone injections while waiting for meds to get sorted. Within 48hrs I went from a hobbling mess who couldn't squeeze a bottle of shower gel to feeling like I was 18yrs old again!

[Nocturne123]

Sunshine pickle that sounds fab , especially as you were in the same situation ttc. Glad to hear there's something a bit safer during pregnancy ( or whilst ttc anyway)

I couldn't move my neck at all this morning , must have looked about 70.

Ah you lot have really helped nice to talk to people who understand

[hellomynameis]

The Arthritis Research UK website has some useful patient leaflets regarding PSA and also with Arthritis & pregnancy.

[ToddleWaddle]

Op could have written your post. I saw rheumatologist a few months ago and had a steroid injection which has thankfully calmed everything. Manageable without pain relief now. If we have dd3 may consider going back on methotrexate as it suited me at least in the short term. Definitely worth a go. I had injection after dd1 too.

[Nocturne123]

I know it's an old thread but thanks so much for all who replied ! Off to rheumatologist tomorrow to have a chat about which drug would suit me best !

Big step for me as I've been a huge chicken about going again thanks everyone