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Seagle1963 posted:
Ok, I am a bit lost. I got diagnosid with RA in 2009. I had always worked on my feet, and used my hands, and just chalked it all up to age and abuse. I had enough bone loss that I retired (thank God for that insurance policy). I started out on MTX, then MTX and Humira. About a year later, the bone loss had slowed, but not enough, so I switched from Humira to Enbrel. Had a slowing/stoppage of bone erosion in hands and wrists, but then the feet took off. I also started developing inflammatory artheritis in my hands, for which we added Cymbalta. Now, we have switched the Enbrel to Symphoni. I will say the Symphoni is a much easier shot that either Enbrel or Humira. Has anyone else had anything happen like this? I am beyond frustrated (aren't we all), and want it "all better right now". I have had a few flares in the past, which responded well to prednisone.
The kicker of all this is I will only be 50 in January. Honestly, I am not sad or depressed, but I am, well, pissed off about it all.
Scott Zashin, MD responded:
For most of my patients, I will combine a biologic like Simponi with a DMARD such as MTX, Arava or Plaquenil to increase the chance of effectiveness. I typically prescribe the MTX by weekly shot to increase absorption.
Seagle1963 replied to Scott Zashin, MD's response:
Thanks Dr Zashin. I have been on MTX from the get go, every week at 0.3ml. We have attempted to go up on the dosage, but my liver enzymes always spike (and no titers for any of the Hepatitises). The only other think I take is advil for pain and flexaril prn at bedtime. The flexaril is actually more for my back...I had a laminectomy at L2-4 in 2003, but still have bulging discs at T1-2 and T 5-6. If I overdo anything, my back lets me know.

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