What has been others expirence with Arava?
In times past, I have used Arava and because of negative impacts I had to stop the medication. What had been the experience of others who use Arava?
If I am switched back to Arava, I would stop using methotrexate of course.
I trialed Arava in 2019. As we increased the dose to the therapeutic range I had problems with hypertension and headaches. I was also on Actemra at that time and my RA was out of control. Looking back, I’m not sure the problem was Arava or RA. I am currently on Ruxience without a DMARD. I expect to address adding a one, possibly Plaquenil, into my plan at my next appointment. After an in depth discussion with my doctor, I would consider re-trialing Arava with close monitoring. I Hope you find just the right combo for you, Jo 
Hi
. Just to follow up on some of what has already been said, this article discusses combination therapy with biologics and conventional synthetic DMARDs (csDMARDs): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5037499/. Without going too far into the weeds here on the details, it notes the increased efficacy of combination therapy and that methotrexate, barring contraindication seems to be the best drug for this purpose. Of course, each case is different and your rheumatologist may have a specific reason for taking a particular direction. You know how severe Kelly's JRA is and now that they have found an IL-6 inhibitor that controls her disease she is on a monotherapy (with various considerations noted by the doctor, but mostly the control that has been achieved). Wishing you the best. Richard (RheumatoidArthritis.net Team) Thank you Richard, I appreciate your sharing the article! It is inspiring to know Kelly found a monotherapy to help control her disease. Because of my skin cancer, both of my Rheums have suggested considering adding one of the older cDMARDs (Plaquenil, Sulfa?) or possibly increasing the frequency of Ruxience. I think we may repeat imaging this appointment and that may help guide our decisions. I'd love to have a better "picture" of what is going on in my hands and feet, especially OA vs RA. Thanks again for bringing the science! Jo
I was on MTX with Ruxience also, but kept having to interrupt it for infections. I never got a feel for whether it helped me or not. Then I developed squamous cell skin cancer (“the good kind”) and my doc and I pulled the plug on it. Luckily the infections have slowed down. Probably shouldn’t have said that. Better knock on wood! The Ruxience does seem to be working tho!
