Should I start on Sulfasalazine or Methotrexate?

There is a more modern alternative to metho and that is Otezla. http://www.mims.co.uk/otezla-new-treatment-psoriasis-psoriatic-arthritis/dermatology/article/1333618 Speaking from experience, I think it is the best treatment to hit the meds market so far and I am glad my NHS specialist suggested giving it a try :thumbup:

Thanks for the recommendation. I'll ask about that one at my next appointment!

I've tried both. Methotrexate was the best for me. I think it's an individual thing. Everyone reacts to meds in a different way. Try the least aggressive med first. See how you go, and good luck.

I was Diagnosed about 10 years ago with PSA. It was a difficult time as I went from being very social/active to a lot of pain, swelling and 'dis'ability in a mattter of months (a very sudden and severe onset). I needed crutches and a wheelchair to get around for about 8 months. I was put on Sulfasalazine and Naproxen initially and it took several months to see any improvemnt but when I did it was enough to start to see some light at the end of the tunnel. A few years later I decided to lose some weight and get more active again. I weened myself off of meds with naproxen as needed. I am currently off any meds except enstilar for my skin and other than some manageble pain, I am back to (almost) where I was prior to diagnosis. Thinking back, I remember being pressured by the doctor to go on Methotrexate and that Sulfa would not be strong enough to endure long term of the disease. He also said if I didn't eventually get on the biologics that I could become crippled with Arthritis. As I understand it, there is more or less a kind of ladder of meds, Sulfa being on the lowest rung. You will be told (and perhaps it's true) that eventually certain meds will become ineffective and you will need something stronger. Once you start to go up, you can't go back. Methotrexate is basically a mild chemotherapy drug...before you start on that or anything stronger, understand what it is and the possible side effects. I was 29 when I was diagnosed and told that to go on methotrexate that I would have to go on birth control (which I was not on) and would have to be off of the methotrexate for a min of 6 mnths before trying to conceive. I didn't like the sound of any of it and I'm so glad I didn't just listen to the advice (pressure) of the doctor. After one appt that I left crying (after he told me I would end up crippled), I went to another rheumatologist who advised that if i thought I might want to conceive within the next few years, I should come off everything! It's now been over 5 years since being on any prescribed meds, (I just use advil, tylenol for arthritis and heat packs when I need it) and I now work as a residential painter (and do small garden jobs in warmer months). I consider myself 75-90% in remission of the severe, daily pain of the arthritis. Do your research, get second opinions, and know that you can do a lot of pain management without perscription meds. Good Luck!

SelfSalazapryn I found better. Methatexate cleared my skin and made my joints better but the side effects were horrible.j only stayed onit for 3 months Selfsalazpyryn I preferred,it did not in the slightest surpress my psoriasis but it did calm my arthuritus a lot..With no side effects..Methatrexate reminded me of rat poison ..But every ones different how ever selfsalazpyryn is less side effects