Methotrexate VS Sulfasalazine

I haven’t taken either but if it’s not working after 2 years it would probably be sensible to try something new. Everyone is different and react differently.

If the MtX ain't working, i'm sure your not going to loose out trying something else.

If there is one thing that I take from the various threads on this forum it is that the reactions to the various available medications are very individual. What works for one person does not for another - and vice versa. It is definitely worth trying another treatment if methotrexate is not working fully for you, but be prepared for it to be just a step on the way to finding the right treatment. I was diagnosed with PsA more than 10 years ago (and skin psoriasis many years before that). At the time I was not offered a choice, was put on sulfasalazine, and except for a short period a few years ago have been on it ever since. I have found sulfasalazine very effective for my PsA. It is harder to say how effective it has been in relation to my skin psoriasis as that was under quite good control when I first went on sulfasalazine. A couple of years ago my rheumatologist switched me on to methotrexate because she was concerned about the high dose of sulphasalazine I had been on for a long time. Perversely, although I found that while on methotrexate my skin psoriasis improved, it was completely ineffective against my PsA so I went back on sulfasalazine (but a lower dose). On the lower dose of sulfasalazine my skin psoriasis has deteriorated markedly (which at least implies that the higher dose was helping keep it under control) and my PsA has been noticeably worse than it was on the higher dose. As a result I have recently started on adalimumab (a biologic treatment) which for me has been transformative in relation to both PsA and skin psoriasis. At the very least trying sulfasalazine will bring you that much closer to qualifying for biologic treatment if that is what you ultimately need. Under current NHS guidelines in most regions I believe you need to have failed to respond to at least two different DMARDs before biologics will be considered.

Hi there. Although I have posted about methotrexate here I thought I would give you some info. The pathway I was given when diagnosed with PsA (having Psoriasis for years beforehand) it stated to start the methotrexate and then some would have sulfasalazine added to it. The opinion was that the methotrexate is good for the skin psoriasis (I disagree as not helped much at all) and the PsA would benefit with the addition of the sulfasalazine. For me the side effects were so awful on both (bad enough just on the methotrexate) that I’ve recently taken a break from all of it. I’ve practically begged to be tried on biological treatments as I want to improve and have a better quality of life as well as not being washed out by the side effects. There are so many different types to try yet some Rhuematology departments are not doing enough to explore all the options that should be available to us. My point is that for me it’s not working but as the previous answer says; we are all different and what works for one doesn’t work for another. Maybe you can see if they will give you both drugs as this may work really well for you. I hope you get the right treatment for you and send you my love xx