I was diagnosed a year ago with RA. I have been on Methotrexate since the beginning of Dec07. Started out at 10 mg, then to 12.5, now at 15(for the last month). My sed rate is now at 6. It has been no higher than 13. I have virtually no morning stiffness, am VERY active (I feel). I take no other medication for pain. In fact, I have little pain. My new RA Dr. wants to put me on Humira to kick a type of "remission" into gear. Wants to try to reduce the methotrexate once I am on the Humira. I have one liver enzyme that remains high( the ALT I believe--which is at 37). The side effects of Humira concern me, but I'd like to prevent damage if that's possible. Any advice? I am kind of anti-medication, but am willing to listen to reason. I truly believe my RA was triggered by a series of Hepatitis vaccines.
Q: Does my condition warrant additonal medication?
That the first half of your question, I wondered why on earth your doctor wanted you off the methotrexate in favor of another, in my view more serious, medication like Humira. Then you mentioned your high liver enzyme and that's when I started to understand. I don't know the specifics of which liver result is bad when you take meth, but I do know that the reason you're monitored as closely as you are with frequent blood tests while on the drug, is to get you off it the minute your liver function is affected. This is likely why you rheumatologist want you to switch medications.
I definitely understand your hesitance to take any drugs, but over the years, I've learned that medications are a tool to help me live my life. Right now, you're not very affected by your RA and I'm pretty sure that your doctor is dedicated to keeping it that way. The goal in rheumatology these days is to keep people who have RA as unaffected by the disease as possible, preventing joint damage and keeping you functioning at close to a "normal" level. This has become increasingly possible thanks to the biologic drugs like Enbrel, Remicade and Humira.
In making this decision, you have to ask yourself about the possible consequences of not switching meds, as well as the possible consequences of not getting kicked into remission. Involve your doctor in this process - poke around on the Internet, research the options and consequences and discuss your questions with your doctor. Ask him to elaborate his reasons, talk more about the liver enzyme, ask about studies and any other information you feel you need to make an informed decision. At the end, you're the one who has to live with the possible side effects, as well as the benefits and it means that you're the only one who can make this decision.
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