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Doctor insights on: Efficacy Of Methotrexate Treatment In Lupus

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In treating Rheumatoid Arthritis, what are the pros/cons of managing it long-term with Prednisone vs. DMARDs? Do all DMARDs increase cancer rates?

In treating Rheumatoid Arthritis, what are the pros/cons of managing it long-term with Prednisone vs. DMARDs? Do all DMARDs increase cancer rates?

See details: Prednisone has major side effects far worse than DMARDs and it does not prevent joint damage. There is a very small increase risk of lymphoma with some DMARDs. As a rheumatologist I try to never use prednisone long term. ...Read more

Methotrexate (Definition)

Methotrexate was originally used in the early 1950's as a treatment for cancer but was also found to be effective in many other diseases including rheumatoid arthritis and psoriasis. It has anti inflammatory and immunosuppressive properties which make it an excellent first line therapy for RA ...Read more


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Is there a difference in humira and enbrel (etanercept) treatment of psoriasis?

Is there a difference in humira and enbrel (etanercept) treatment of psoriasis?

No great...: No great differences. Enbrel (etanercept) is once weekly and Humira is once every two weeks. They have similar efficacy in large trials, but differences exist between individuals! both should be tried only after Methotrexate therapy has failed! ...Read more

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Is there any ongoing research for the use of low dose naltrexone in autoimmune diseases especially in the case of bullous pemphagoid.

Is there any ongoing research for the use of low dose naltrexone in autoimmune diseases especially in the case of bullous pemphagoid.

Stetchy research: There is some sketchy research and documented experiences of MDs using low dose naltrexone for this purpose with success. Naltrexone is largely without any complications (unless you regularly take narcotic pain medication - in which case skip it.) Since there is almost no downside it is worth a try if traditional treatment is not giving you satisfaction. ...Read more

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What is the standard dose of methotrexate for treating psoarisis?

What is the standard dose of methotrexate for treating psoarisis?

15-25 mg weekly: There is no one standard dose. I have found that a range of 15-25 mg weekly works best for most of my psoriasis patients. ...Read more

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Why hydroxychloroquine is effective in treating systemic lupus erythematosus?

Why hydroxychloroquine is effective in treating systemic lupus erythematosus?

It is magic?: 1the use of anti-malarials in autoimmune diseases was accidentally discovered in treating wwii vets for malaria. Those with RA improved. Chloroquine and ho-q were tested in sle, with very positive results. In the early 80's canadian researchers definitively showed fewer sle flares with ho-q. It is considered the rx of first choice for :sle. We now understand more of the mechanisms, but not all. ...Read more

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Why we use antimalarial drugs in treatment of systemic manifestations of sle?

Why we use antimalarial drugs in treatment of systemic manifestations of sle?

See details: Hydroxyxhloroquine (plaquenil) is used because it is not only proven to be effective in treating the common manifestations of lupus but it helps to prevent more serious problems from occurring in the future. ...Read more

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Thoughts on safety and efficacy of major autohemotherapy for chronic lyme disease. This treatment has been recommended along with silver iv.

Thoughts on safety and efficacy of  major autohemotherapy for chronic lyme disease. This treatment has been recommended along with silver iv.

Very promising but..: Major autohemotherapy using ozone is a cutting-edge treatment which is more widely used in Europe but a growing # of innovative docs in the US are offering it. I'm not aware of research on it for Lyme but there are studies showing it to be safe and effective for macular degeneration, Hep C, eczema and other conditions and many case reports of success in chronic Lyme. See http://tinyurl.com/z5jrlnq ...Read more

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Are the benefits of prednisone worth the risks for leukocytoclastic vasculitis?

Are the benefits of prednisone worth the risks for leukocytoclastic vasculitis?

Not enough info: Only your doctor knows the answer to this question. It depends on your illness and other factors. Ask your doctor and good luck! ...Read more

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Is it better to be on 25mg methotrexate injections (53pounds) or lower dose of methotrexate along with a biological in treating juvenile arthritis?

Is it better to be on 25mg methotrexate injections (53pounds) or lower dose of methotrexate along with a biological in treating juvenile arthritis?

JIA treatment option: There are 2 schools of thought. One is to be just on one medicine if you can if that controls the arthritis. If the arthritis is poorly controlled, than add a 2nd medicine. The other approach is to start with multiple medications to get the arthritis under control and then pull back later. Either approach is reasonable. I think many doctors try and just treat with one medication if possible. ...Read more

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What are some benefits and dangers of prednisone in treating pmr - polymyalgia rheumatica?

What are some benefits and dangers of prednisone in treating pmr - polymyalgia rheumatica?

See answer: Benefits include resolution of pain. Risks include increase in cardiovascular disease, osteoporosis, fragile skin and blood vessels, weight gain, mood changes, psychosis etc. Typically the benefits greatly outweigh the risks. ...Read more

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Has any one taken the disease modifying drug (dmards) for their psoriatic arthritis?

Has any one taken the disease modifying drug (dmards) for their psoriatic arthritis?

Most patients need a: Psoriatic arthritis can be a very inflammatory disease. We all want pain relief for our patients, but rheumatologists understand the need to reduce inflammation, because it portends coniued damge to joints, as well as much earlier cardiac disease. My personal favorites: sulfasalazine with methotrexate, the latter given sc. Some, albeit few, patients need tnf-alpha inhibitors. ...Read more

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For the treatment of psoriasis,are any of the systemic medications available for use with guttate psoriasis in an adult?

For the treatment of psoriasis,are any of the systemic medications available for use with guttate psoriasis in an adult?

Guttate psoriasis: Janet: guttate psoriasis can come on due to infections like streptococcal infections, or medications like beta blockers (blood pressure med); so be sure not secondary to infections/ drugs. Treatment usually topical (can be difficult with many spots!); UVB or PUVA light treatment can be effective. Medications like methotrexate are also effective in severe cases. Work with your Dermatologist. ...Read more

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What are effects of taking methotrexate for rheumatoid arthritis?

What are effects of taking methotrexate for rheumatoid arthritis?

Works: Methotrexate has become the standard of first choice forra treatment but rarely results in remission, ie no one can tell if you have it including the doctor. The risk is extremely low, although you cannot use alcohol, and is not usually used if ther is preexisting liver disease. Most patients have to add several other disease modifying drugs to get better. ...Read more

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What are the latest conclusions regarding the use of biologics for treating psoriasis?

What are the latest conclusions regarding the use of biologics for treating psoriasis?

Highly effective: The use of biologics has transformed the management of psoriasis and their use has led to significant remissions of the disease. ...Read more

Dr. Robert Lowe
341 doctors shared insights

Rheumatrex (Definition)

Rheumatrex ...Read more