I have recently been diagnosed with RA and am currently on Methotextrate 15 mg. If my symptoms are pretty well controlled, how do I know there is not underlying joint damage still going on? My feeling is I should have some x-rays of my joints to show joint damage and possible inclusion of a biologic like Humera in my therapy. Does that make sense?
Methotrexate is a great first-line drug and about 50% of folks who are started on it for RA have a perfectly good response, at a dose of about 15-25 mg per week. There are several things that go into the decision to increase a drug dose or to add a second dose (such as Humira). These are: 1) does the patient feel better? 2) are the joints less swollen and less tender? 3) are the markers of inflammation in the blood down? If these are all a “yes”, then the drug is most probably working very well. We would still recommend getting an xray of the hands and feet every 1-2 years, though, as you suggest, just to make sure that no significant damage is occurring.