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What are the options for persistent joint pain despite Methotrexate?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

My aunt, who is 50 years old, was recently diagnosed with rheumatoid arthritis. She has been on Methotrexate for a few months, but unfortunately, her pain continues to worsen, particularly in her wrists and knees. She is experiencing such difficulty walking that she is now using a cane to move around. Her doctor mentioned that her RF is at 110 IU/mL and her CRP level is 24 mg/L, indicating some inflammation. However, despite being on treatment, her joints continue to swell each day, and the stiffness is becoming unbearable. She is feeling very frustrated and hopeless about her condition, and it is significantly affecting her daily life.

We have been exploring other treatment options, and her doctor has suggested considering biologic medications. Is this the appropriate course of action for her, or should we investigate other treatments first? She is feeling overwhelmed, and we want to ensure that we are making the best decision for her.

Kindly provide your guidance.

Answered by Dr. Raveendran S R

Education:

MBBS

Professional Bio:

Dr. Raveendran S R is a dedicated diabetes specialist and sexual medicine expert committed to providing evidence-based, confidential, and patient-centered care. With strong clinical and academic experience, he specializes in managing diabetes, erectile dysfunction, male infertility, performance concerns, and other men’s health conditions through structured and scientifically guided treatment approaches. Dr. Raveendran focuses on accurate diagnosis, personalized treatment plans, and long-term health improvement while ensuring patient comfort and privacy. Known for his compassionate and professional approach, he believes in clear communication and helping patients make informed decisions to improve their overall health, confidence, and quality of life.

This doctor is not available for online consultations on the platform anymore.

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

Not responding well to Methotrexate can occur in some cases. Given her elevated rheumatoid factor (RF) and C-reactive protein (CRP) levels, it may be time to consider biologic medications.

Biologic medications target specific parts of the immune system that cause inflammation and are often used when traditional disease-modifying antirheumatic drugs (DMARDs) like Methotrexate are not effective. These medications can significantly reduce pain, inflammation, and joint damage, thereby improving quality of life.

It is important to discuss biologic options with her doctor, including the potential risks and benefits, as a next step in better managing her rheumatoid arthritis.

I hope this has helped you.

Kindly follow up if you have more doubts.

Thank you.

Medically reviewed by iCliniq medical review team
Published At January 9, 2025
Reviewed At January 9, 2025

Education:

MBBS

Professional Bio:

Dr. Raveendran S R is a dedicated diabetes specialist and sexual medicine expert committed to providing evidence-based, confidential, and patient-centered care. With strong clinical and academic experience, he specializes in managing diabetes, erectile dysfunction, male infertility, performance concerns, and other men’s health conditions through structured and scientifically guided treatment approaches. Dr. Raveendran focuses on accurate diagnosis, personalized treatment plans, and long-term health improvement while ensuring patient comfort and privacy. Known for his compassionate and professional approach, he believes in clear communication and helping patients make informed decisions to improve their overall health, confidence, and quality of life.

This doctor is not available for online consultations on the platform anymore.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Education:

MBBS

Professional Bio:

Dr. Raveendran S R is a dedicated diabetes specialist and sexual medicine expert committed to providing evidence-based, confidential, and patient-centered care. With strong clinical and academic experience, he specializes in managing diabetes, erectile dysfunction, male infertility, performance concerns, and other men’s health conditions through structured and scientifically guided treatment approaches. Dr. Raveendran focuses on accurate diagnosis, personalized treatment plans, and long-term health improvement while ensuring patient comfort and privacy. Known for his compassionate and professional approach, he believes in clear communication and helping patients make informed decisions to improve their overall health, confidence, and quality of life.

This doctor is not available for online consultations on the platform anymore.

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