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More information on RA medication needed
sanjuktadebroy posted:
I have been disgnosed with RA from 2004 onwards it started with my shoulder and from then I am being on medication Methotrxate 15mg weekly and HCQS daily and time to time on corticosteroids. But the symptoms are getting worser and I am having persistant pain and swelling in my right wrist nothing is helping. My ESR IN 20 and CRP is negative, Anti Nuclear Antibody tested in 1:80. Need some advice what to do next.
Scott Zashin, MD responded:
In my patients with RA and localized activity, eg one joint. I will offer patients a steroid injection if there are no signs or symptoms of infection. In patients with active RA, I will maximize oral methotrexate to 20mg once weekly(assuming no contraindications) and then switch to injectable MTX if no benefit after 3 months which may be absorbed better. In patients with active RA who do not responde to plaquenil and methotrexate, I will add low dose sulfasalzine or change to a biolgic such as Humira or Enbrel.Some patients with RA may have a positive ANA but I always exlude Lupus as best as possible in my patients with a Positive ANA through additional blood work.

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