Meds, Mind, Body & Benefits > Questions About Treatment & Side Effects

methotrexate for arthritis (immunosuppressant)

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ademas:
Does anyone have any experience with methotrexate?

I have this prescription sitting in front of me that I'm supposed to start today, and I'm a little freaked-out about it.

My last labs are CD4's 588, 24%, VL undetectable.  It's taken 12 years of HAART to get them this high, and now both my ID doc and the RA doc are in agreement that I have the leeway in my numbers to start treatment for my psoriatic arthritis, and they agree that I need to.

The "immunosuppressant" classification alone is making it difficult to jump onboard...let alone the list of possible side effects.

Anyway...I know it's a long-shot, but I thought I would throw it out there, just in case any of you have experience with it.

Thanks,
Craig

gerry:
From theUCSF Website:

"At our institution, treatment of patients with severe arthritis with low doses of methotrexate (5 to 10 mg per week) has led to rapid (< 4 weeks) improvement in inflammatory joint symptoms as well as improvement in skin lesions. Methotrexate can be given until the skin and joint disease is under control, then slowly tapered by 2.5 mg per month, aiming for a maintenance dose of 5 mg per week. Patients must be monitored closely, because there are anecdotal reports of progressive immunodeficiency and opportunistic infections in HIV-infected individuals with Reiter's syndrome who are treated with methotrexate. Systemic glucocorticoid use is generally discouraged because of increased risk of infection, but intra-articular steroid injection (every 4 to 6 months) may provide substantial relief to individual arthritic joints."

ademas:
excellent information, gerry.
Thank you.

ademas:
I've been on methotrexate for 6 weeks now.

My latest labs:

CD4 - 418 (down 170)
% - 19% (down 5%)
Liver Function remains well WNL, and is actually quite good.

I also tested positive for RA (Rheumatoid Arthritis), which is interesting.  It doesn't change the treatment course, but my symptoms could be compounded by two varieties of arthritis.

It's a bit disconcerting to sit back and watch the CD4's and percentage drop so quickly.  It's taken me forever to build them up (12 years).

Ann:
Hi Craig,

I think that percentage drop would alarm me too! Is the methotrexate providing you with any relief? I live with a lot of joint pain too, but without an obvious cause as I've tested negative for the things you've tested positive for. (aside from the obvious) The only thing that brings me real relief are cannabinoids - which of course isn't ideal at all. Aside from the illegal aspect, it's exceedingly difficult to get a hold of where I live. There's plenty of heroin on the market here (no, I don't...), but pot, forget about it. I guess it's easier to smuggle heroin over the Irish Sea than smellier pot. I think it's criminal that it's not available here for medicinal use.

But anyway, I hope the stuff is at least giving you relief from the pain and other symptoms that you're dealing with. I've got my fingers crossed for you that you do not experience further drops in your numbers.

Hugs,
Ann

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