I would get extreme fatigue from methotrexate. Had to stop using it because of liver problems. Do you get regular labs? Make sure your liver function is o.k. Anemia can also be a problem with RA. Had to do iron infusions a few times.

Not familiar with Cosentyx. Just looked it up and it's for psoriasis and psoriatic arthritis. I know RA causes general fatigue. It's just part of the disease. Could be the disease or could be a side effect from Cosentyx. I don't find that Methotrexate (rasuvo) causes me any additional fatigue.