My understanding is that mtx is not to maintain pain control, it is to get RA under control.

After a few months on MTX, I was still having pain for hours, swollen joints for hours, usually at about a 6-7 in the feet. After a few hours, it would decrease, only to start up again the next morning. When MTX did not help, a biologic (Humera) was added. Are you seeing a Rheumatologist, or a primary care? If you are not seeing a Rheumatologist, you should get an appointment. Is there some reason you that a biologic is not being added, in addition, to the MTX?

Once a biologic was added, this is when I got relief. When the biologic did not help as much as my Rheumatologist thought it should, I was switched to another biologic.

Again, I don't think that mtx is for pain control. For that, I was taking Celebrex.

It is my understanding that mthx and Arava are about the same level for stopping RA. So I have concerns that switching from one DMARD to another is not going to be the answer.

If you are not having problems with mthx, I would ask to go on a biologic, before you switch to Arava. Leave it for down the road, if mthx fails.

I was on mthx for 5 years and it was never enough. I was in constant pain. But when I added the biologic, the disease was under control, and I did not need any kind of pain management.

The goal is not pain management, but stopping the disease. If you stop the disease, you won't need pain management. It is possible to achieve that, although not for everyone, and not all the time for others (like me). When mthx and Sulfasalazine failed, I lost the 100% control of the disease, and I have rarely found it again.

So do ask your rheumatologist to add a biologic. Arava will just be more of the same. And do have a rheumatologist, a GP is just not equipped to deal with RA.

we can't doctor on here - what I was told when I switched to arava, is that they are different dmards and that some folks in early diagnosis or not get a response from arava that do not from mtx. i've known folks on here who do tandem. you have only been diagnosed for 5 months. i figure your rheumatologist is working her way through the dmards. ask her what her reasoning/action plan is.

controlling inflammation does control pain for me, sometimes, ask your rheumatologist if that is what she/he meant on next visit :)

depot

Thanks for your responses. Depot, If I remember right that is exactly why he thought about a change. He did say that sometimes one or the other of the DMARDs work better, depends on the patient. My memory is a little fuzzy these days and I hadn't remembered that little part. :) I'll do a little more research on them. I'm sure that when the disease is under control the pain will also be. I really like to be involved in the decision making process but recognize that my thought processes are not always optimal anymore so I do rely heavily on my medical team. I am grateful for all the emotional support you all give me as I have days that I'm just frustrated with the whole thing. Hugs to all.

Hi Grandmacm,

I am also a grandma. ;) Your question prompted me to go online to view my medical records from 2009, and I'm glad I did because I actually forgot all of the reactions I've had to the various drugs offered from 2009 until now.

Here is what I wrote to my doc about Arava:

I don't think I'm going to be able to continue on the Leflunomide (Arava). I have been having diarrhea from it (no cramps) and I also think it may be causing an unpleasant squeezing sensation in my chest. This happened to me about 15 years ago when another doctor prescribed Synthroid for me.

I have seen a cardiologist in the past week (Dr. Riddick) and he thinks my heart is fine.

hi

I took Arava for several months a couple of years ago. I really liked Arava. It really did help with my joint pain, and the other complications I was having at the time too. But it raised my liver profile, so the doc stopped it but I wish i could stayed on it. Maybe taken half the dose or even started with a lower dose and advanced slower to give my system time to adjust to it. Maybe I should have drank more water with it. I wanted to keep it. I thought it was like taking a low dose of methotrexate, prednisone and ibuprofen all in one pill. It felt great after the first week. I was sad to lose Arava.

I would like to try it again. I really did like how it worked for me. But we are all different.

I hope you try it and I hope you like it too. I wish you the best.

If you do try it, let us know what you think.

I have been on Arava for several years now. I switched to it from methotrexate, but only because I was having terrible mouth sores. My doc explained to me that Arava was similar to and would play the same role as MTX. For me, biologics were added in early and the MTX and then Arava are part of a combo therapy, along with Plaquenil. If you read the literature about the biologics, most of them were tested with MTX, not on their own. Since it's the "gold standard" for RA treatment, I actually wish I could be on it instead of Arava.
Caren