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Real members of myRAteam have posted questions and answers that support our community guidelines, and should not be taken as medical advice. Looking for the latest medically reviewed content by doctors and experts? Visit our resource section.

Methotrexate V Biologics for immune system

A myRAteam Member asked a question 💭
Elgin, UK

I see my Rheumy tomorrow and wondered if anyone could advise. I live in Scotland, I only have access to one Rheumatologist and he isn't the best but you take what you are given on the NHS. I was on methotrexate for around 18 months and I asked for a break as I was getting infections every 4-6 weeks, usually urine infections but also chest, sinus etc. I am allergic to most antibiotics and was finding it harder and harder to get rid of the infections. I have been off mtx for over a year now and… read more

October 8, 2015 (edited)
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Answer Summary

Members shared their experiences comparing methotrexate and biologics when managing rheumatoid arthritis while dealing with frequent... Read more

Members shared their experiences comparing methotrexate and biologics when managing rheumatoid arthritis while dealing with frequent infections, with several noting that biologics transformed their lives despite sometimes suppressing the immune system more than methotrexate. Several members offered practical strategies including taking prescription folic acid daily to reduce infections, exploring alternative medications like Arava or Actemra, practicing rigorous hygiene with saline nasal rinses and hand washing, and staying vigilant about avoiding sick contacts and dressing warmly in cold weather. A recurring theme was the frustration of limited access to biologics and the difficult balance between controlling disease progression and managing infection risk, with many emphasizing that staying on some form of treatment is essential to prevent irreversible joint damage.

A myRAteam Member

Take 1 gram of folic acid daily to combat the infections caused by methotrexate. I've been taking mtx for seven years and I can't remember having an infection ever.

I'm surprised this isn't known so well among doctors. It's a simple fix to a complex problem.

Mtx depletes the folic acid in your body and you cannot replenish it on your own. Hope this helps.

October 12, 2015 (edited)
A myRAteam Member

Not sure which biologics are available in the UK to be honest. I raised my concerns with him and he couldn't have cared less, it was either a case of go back on Methotrexate or just manage the RA with painkillers. As I am seeing and feeling joint destruction I have chosen to go back on mtx but am not happy about it. My friend has recently lost her step dad to an infection caused while on methotrexate and he couldn't fight it off which is my biggest worry with being allergic to most antibiotics :(

November 2, 2015 (edited)
A myRAteam Member

Is Arava available where you are? I had soo many problems on MTX, I finally refused it. Dr suggested Arava - he was not happy about it tho. I do great on it - 1/4 of the infections I had on MTX. I take it every day... and when I am off of it - I can tell.
Maybe its an option for you?

October 30, 2015 (edited)
A myRAteam Member

You have a problem! I am on a world wide biologics study at the moment. My infection count came down from 74 to 13. BUT I have to take very good care of myself so as not to get any infections. So I stay away from people with any infectious illness, in winter I don't go out in the cold and especially not in the evenings. If I have to go out I dress warmly. Fortunately I can tolerate antibiotics but haven't needed some all year. You cannot be on no meds for the RA. And so far the only meds that work are immune suppressing meds.

October 13, 2015
A myRAteam Member

How do you like the xelijaz? I'm on Rituxin and it makes me very sick!

October 13, 2015

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