Hi Nina and Mattias,
Wow! Thanks so much for all this great info and helpful input! I will have quite a bit to discuss at my Rheumy appt., and probably way more than time will allow.
I can imagine being able to avoid nausea only if I drop the nsaid and/or ssz before trialing mtx. Right now (and even before starting Remicade), if I took anything over a T3 I'd be instantly struck with nausea to the point of complete intolerance.
But, if I do drop voltaren and ssz to start taking mtx, then that means rocking the boat in no small way. Yep, I am very lucky to have an iron clad stomach and good tolerance for what I'm taking currently.
I still can't find info regarding trials that relate to ssz and Remicade alone, to know if the effectiveness of Remicade could be maintained this way, or if they just haven't studied this combo yet. I keep wondering if ssz has any potential (or none) to hinder development of antibodies against remicade. In my case, boosting the effectiveness is not a driving issue to make a switch, yet.
Mattias, thanks for including the great visual history of your levels as you progressed through meds. It certainly looks like mtx and remicade are both culprits in your case for elevating liver enzymes.
I'm glad to see your levels are returning to normal on the lower dose. I also found a disturbing contrast in noting the frequency of your lab work. No-one here seems to care or ever ask for blood except when I push them to do it. I will not be adding mtx without assurance they'll keep a closer eye on things.
I have no real need to make a change right now on the basis of how well I'm doing, but I'll see what my fav Rheumy has to say about the potential for antibodies crashing the party. Prevention may be the most important long term consideration, but preventing liver troubles or antibodies to remicade is where a crystal ball would really come in handy.
I really appreciate the time you've both taken to help answer some of these questions for me, and hopefully it's helped Cheryl too! (Sorry
to have side-tracked your original query Cheryl, I really didn't mean to hyjack your thread!) It is good to know that mtx boosts the effectiveness of Enbrel also, although the reason for it's inclusion may differ somewhat between the biologics. All this is helpful towards making the best treatment decisions and limiting our risk.
Thanks again!
