I am 6 weeks into tx with methotrexate/plaquenil for rf-negative arth. initial improvement after 3 wks, now bad flare. have i failed the treatment?

Problems in limbo?: Methotrexate takes about a month to work, and Plaquenil (hydroxychloroquine) takes about two months to work. In addition, sometimes the dose of Methotrexate needs to be increased over a few months. Sometimes seronegative arthritis is difficult to treat, and misdiagnosis is common. You'll need to stay in close follow up with your doctor.

No: Plaquenil (hydroxychloroquine) generally takes 6-12 weeks to be effective and can take up to 6 months to reach its maximum benefit. Methotrexate can take 2-3 months and the dose can be increased to as high as 25 mg weekly if lower doses are not adequate.