Health Boards
Mon-01-07-2013, 12:39 PM
I wouldn't say that MTX is pointless for treating PsA. This time last year I was crippled by inflammatory fluid build up (synovitis) around the joints, nerves and tendons of my wrists and hands. I tried every precription pain killer and anti-inflammatory that my GP could prescribe me before being given MTX by my Rheumy.... Within 48 hours the inflammatory fluid had gone and so had the pain, stiffness and feelings of complete uselessness.
Not all drugs work for everyone, I know that most topical treatments do nothing for my skin, and the data presented in this paper is interesting with regards to the efficacy of MTX on PsA especially that the data seems so negative especially considering the type of response I have had to it but I agree that the evidence for halting the progression of PsA is limited in the case of MTX.
Also, the clinical test size is too small (in my opinion), you need a far larger group to say definitively that it does not work.. for example, how many dropped out because the MTX had a positive effect? How many through side effects? How many of the Placebo candidates left because the PsA was too painful and had to be prescribed other drugs?
As for Biologicals, they are indeed much worse for the immune system than MTX. MTX only interacts with one biochemical pathway which can be counteracted by the simple act of taking a folic acid supplement, to my knowledge there is nothing to take to counteract the actions of any of the biologicals and the pathways they tend to disrupt have much more far reaching effects on other cells of the body than MTX does.
That said, I'm not saying that MTX is for everyone....
Not all drugs work for everyone, I know that most topical treatments do nothing for my skin, and the data presented in this paper is interesting with regards to the efficacy of MTX on PsA especially that the data seems so negative especially considering the type of response I have had to it but I agree that the evidence for halting the progression of PsA is limited in the case of MTX.
Also, the clinical test size is too small (in my opinion), you need a far larger group to say definitively that it does not work.. for example, how many dropped out because the MTX had a positive effect? How many through side effects? How many of the Placebo candidates left because the PsA was too painful and had to be prescribed other drugs?
As for Biologicals, they are indeed much worse for the immune system than MTX. MTX only interacts with one biochemical pathway which can be counteracted by the simple act of taking a folic acid supplement, to my knowledge there is nothing to take to counteract the actions of any of the biologicals and the pathways they tend to disrupt have much more far reaching effects on other cells of the body than MTX does.
That said, I'm not saying that MTX is for everyone....