• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

Johns Hopkins Arthritis Center

Show Search
Hide Search
  • Disease Information
    • Rheumatoid Arthritis
    • Psoriatic Arthritis
    • Ankylosing Spondylitis
    • Osteoarthritis
    • Gout
    • Osteoporosis
  • Patient Corner
    • Drug Information Sheets
    • Managing Your Arthritis
    • RheumTV – Patient Education Video Library
  • Our Research
    • Patient-Centered Outcomes Research
    • Current Research Studies
    • The Camille Julia Morgan Arthritis Research and Education Fund
  • About Us
    • Appointment Information
    • Contact Us
    • Our Faculty
    • Our Staff
    • Rheumatology Specialty Centers
  • Donate
Home / Ask the Expert / Methotrexate for Psoriatic Arthritis Treatment

Methotrexate for Psoriatic Arthritis Treatment

January 23, 2009 By Clifton Bingham, III, MD

Question

I am 20 years old and have been diagnosed with psoriatic arthritis for the last two years. I developed psoriasis when I was about 11. My main problems are in my knees and pelvis but recently I have started to feel more and more pain in my wrists and ankles. I am currently injecting 15mg of methotrexate a week, taking tramadol at night and 150mg of diclofenac a day. I feel like things are getting worse. My doctor suggested switching the diclofenac to celebrex but I’m not sure that’s the best solution. I’ve been on methotrexate for six months – at first it was working really well but now my periods of stiffness in the morning are much worse and I’m constantly in some kind of discomfort. Can anyone suggest anything? I feel unable to tackle my rheumatologist who seems to think I should just plod along as I am.

Answer

Methotrexate is certainly used in treating psoriatic arthritis.  As is the case in rheumatoid arthritis doses ranging up to 20-25 mg/week may be required and it may take a couple of months until the benefits of and increased dose are felt.  If there is ongoing inflammation in the joints in spite of MTX, the group of medications called TNF antagonists are often used (Enbrel, Humira, Remicade). For reasons that are not well understood, some patients will feel more benefit from a change from one NSAID to another as your rheumatologist has recommended (diclofenac to celebrex).

Clifton Bingham, III, MD

Professor of Medicine
Director - Johns Hopkins Arthritis Center

Primary Sidebar

Ask The Expert Topics

  • Alternative Therapies
  • Ankylosing Spondylitis
  • Associated With Other Illnesses
  • Bursitis and Tendinitis
  • Corticosteroids
  • Diet and Exercise
  • Disease Modifying Antirheumatic Drugs (DMARDs)
  • Enteropathic Arthritis
  • Fibromyalgia
  • General Arthritis
  • Gout, Pseudogout, Other
  • Infectious Arthritis
  • Myositis
  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
  • Osteoarthritis
  • Osteonecrosis
  • Osteoporosis
  • Polymyalgia Rheumatica
  • Psoriatic Arthritis
  • Reactive Arthritis
  • Regional Pain: Back and Neck
  • Rehabilitation
  • Rheumatoid Arthritis
  • Surgical Therapy
  • Systemic Lupus Erythematosus (SLE)
  • Systemic Sclerosis
  • Vasculitis
RheumTV Logo

Rheum.TV is an informational platform created to educate patients living with a rheumatic disease. With over 100 disease education videos produced by the team at Johns Hopkins Rheumatology.

Visit Rheum.TV

Footer

Johns Hopkins Rheumatology

  • Johns Hopkins Rheumatology
  • Johns Hopkins Lupus Center
  • Johns Hopkins Lyme Disease Research Center
  • Johns Hopkins Myositis Center
  • Johns Hopkins Scleroderma Center
  • Johns Hopkins Sjögren’s Syndrome Center
  • Johns Hopkins Vasculitis Center

Connect With Us

  • Facebook
  • Twitter
  • YouTube

Johns Hopkins Medicine

© 2023 Johns Hopkins Arthritis Center
Patient Privacy