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Anyone find success with a DMARD that they discontinued then later resumed?

I’ve been receiving treatment for 6 months for RA. My rheumatologist wants to treat it aggressively which is fine by me. I started with Sulfasalazine and after 6 weeks started Methotrexate. After another 10 weeks he said to discontinue the Sulfasalazine in order to start Cimzia. I’ve had 4 doses of Cimzia since then. Meanwhile night sweats which have plagued me which had greatly diminished in frequency and strength when I discontinued the Sulfasalazine have returned. Also, although I feel my wrist, hand, and ankle are fairly well stabilized and under control, my knee continues on its diabolical way. It was better before starting the Cimzia. The rheumatologist has given me permission to go back to Sulfasalazine and I started yesterday.

Whew! That’s a long-winded way to my question - has anyone had a similar experience and, if so, what was it? If you had relief from the resumption of the medication, how long did it take?

I feel lucky in that I seem pretty tolerant to all these meds so far so I’m hoping the trio work! Thanks in advance for anything you can share.

  1. i have not had good success going back to a medication. Generally, it has been forward and on goign back i have found that it never is better than when I stopped and usually it is worse.

    There are many biologics and I hope if you and your docotr to look at others that you find one that agrees with you.

    1. I'm really hesitant to make any suggestions because we are all so unique, especially when considering the antibodies each of us carries. I can only speak from my experience. The only reason I wanted to return to a discontinued medicine was because I started experiencing symptoms that had subsided while I was using the medication and then returned when I discontinued it. The pain and progress of my disease were positively affected by the combination of the meds I was prescribed, including specifically the suppression of the uncontrolled night sweats, as well as a dry cough that I experienced only when fatigued (which was often). My symptoms can well be unique to me and the particular form of inflammatory autoimmune disease I experience, but the medication I resumed does seem to eliminate those specific symptoms 95% of the time. Those symptoms had reappeared when I discontinued one medication. I'm not sure how (if) others experience multiple symptoms some of which one of their meds address, but if, through the process of elimination or in some other way, you can pinpoint a med having this effect, then I would think it to be a candidate for resumption/continuation. It may be that I was lucky in being able to isolate the med in the way it happened to me and that I happened to have had a symptom that was obviously affected.

    2. An example I have went through, might be a good one. Early on in starting treatment aggressively I was put on Plaquenil and then shortly afterward Methatexate was add. I started having a loss in vision (65 yrs old) which had been naturally happening (due my work, age, etc) but it started rapidly gettting much worse and some stomach discomfort. My rheumatologist suggested stopping Plaquenil and getting an eye examine and it was found it was cataracts in both eyes. Wooh, this was good news in that Dr.'s said it was normal and after surgery I was seeing w/o glasses. When the injectable MTX stopped working on it's own, My Rheumy suggested starting the Plaquenil again, for the Prednisone needed to be reduced (I had some bad flares, so 5mg prednisone was added),now that the flares had went away. I was told to prepare myself to end up on a 3tier treatment, which is adding Sulfasalazine. We have not added at present but believe after X-Mas on next RA Appt. 3 mouths on Plaquenil ( hydroxychloroquine) I will be ready to add the Sulfasalazine. I hope this helps. The goal of 3tier is to hopefully not have to move to Humira. I was diagnosed 10/2018

  2. I came to Form/Treatments to see if any RA patients have had to maintain a dose of Prednisone for long term as a compliment to what they are on. Also does/has anyone found help with taking Tylenol regularly/long term for inflammation and or pain.

    1. I had sort of stopped on the forum because I do not know how relevant my case is to anyone else's, as I will explain. I will say, however, that when I was being treated I found Tylenol very helpful. Of course Prednisone was as well, but I did not like taking it at all and sought the alternative.

      Although my rheumatologist sees that my problems have pretty much receded, he feels that I have some kind of an autoimmune disease and is conflicted about releasing me into the wild. I am, however, now on a yearly visit basis. All of my blood work, from anemia to very high CRP and SEDrate readings have gone to zero. Night sweats, unusual spots on my skin that were "interesting" and worth further biopsy, have disappeared. Not long after my original post on this topic, I had an aspiration of my knee. Although swollen and painfully sore, little fluid was obtained. The analysis showed enterococci. Since I had no obvious symptoms of a knee infection, it was deemed a false positive. I continued for another 6 months with a couple of more aspirations that were negative. I had arthroscopic surgery and had some repairs and cleanup of bone spurs and other detritus. The surgeon said I did not present as infected. HOWEVER, the results from analyzing the synovial fluid were that I had an enterococcal infection of my knee. 6 weeks of intravenous vancomycin cleaned it up. All of the symptoms I was experiencing disappeared. My wrist and ankle, the original sites of redness, pain and inflammation, are all normal. I am still building up my knee a year later and although it sometimes is painful, it is nothing like before and I feel that when my muscles are rebuilt entirely I will be ok. I am so grateful for my recovery. Every day I wonder if the pain will return, but I seem to be ok. I truly appreciate what living with pain without relief can mean and I wish that my results could be replicated. There are, of course, questions, like was it really an infection all along...could the infection actually have been so latent and slow that it did little damage to my knee over so many months (2 years), how did I even get enterococci in my knee...how could I not have inflammation in my knee the way I did in my wrist? I have a friend who is treated for RA whose rheumatologist treats with heavy doses of antibiotics at first. I don't know whether or not this is advisable, nor whether it is applicable to me, but it is interesting in light of what happened to me.

      I'm sorry for the long-winded response, but I wanted to set my record straight. Thank you.

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