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Subject: Does drugs' efficacy wear off over time?
My symptoms started about 5 years ago and after a few months on diclofenac, which didn't help at all, I was prescribed hydroxychloroquin (quinine). I have since learned that this is a pretty old remedy for RA (actually, I was diagnosed with "palindromic rheumatism" which can, and does, randomly affect any joint it chooses. It bloody hurts, but apparently permanent joint damage can't be detected by X-ray. It can be a forerunner of full-blown RA but it's pretty rare and as yet knowledge about its advance is sketchy) but it seemed to work for me. After about 2 years, however, the effects of the drug began to wear off and the pain and swelling returned. After about 6 months, in which I had 3 steroid injections (general ones) over the summer of 2008, I was put on methotrexate and again the symptoms went. Initially I had a few side effects (spotty nose, which I put down to the mtx and is a bit odd in a 54-year-old) but they have gone and generally life has been fine. However, increasingly over this summer my symptoms returned and I have had episodes in which different joints have been affected. Mostly it's been my hands and wrists, but about a month ago I had a really bad flare-up in my left foot which caused my calf to swell up so much that I thought that the restriction to the blood flow might have caused a deep vein thrombosis. I spend many hours in A & E waiting to be seen (it was a Saturday) but after a scan on the Monday I was given the all clear. As of tomorrow my mtx is being increased from 12.5mg to 17.5 mg because of these increased flare-ups What I'm trying to find out is whether people on this forum think that their bodies become accustomed to a drug, or whether they think that the advancing nature of the disease can overcome the drug's efficacy. That's probably a daft question because I don't know how you would tell one from the other. Also, what is considered to be a high dose of mtx? I was told that 12.5 mg is low. I've read a few posts about people's hair falling out, but as a bloke in my mid 50s that doesn't bother me. My oldest brother is bald as a coot, as were my father and both my grandfathers so I should expect it anyway! I should add that generally my health is pretty good and I try to keep myself fit through cycling, but I am overweight. Looking through this forum I reckon I'm pretty lucky judging by others' experiences, but it's hard to convince yourself of that at 3 a.m. when both hands feel as though they've been trampled on by elephants.
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