Is methotrexate enough for RA?

Hi Regina,

Methotrexate is a great first-line drug and about 50% of folks who are started on it for RA have a perfectly good response, at a dose of about 15-25 mg per week.  There are several things that go into the decision to increase a drug dose or to add a second dose (such as Humira).  These are:  1) does the patient feel better?  2) are the joints less swollen and less tender?  3) are the markers of inflammation in the blood down?  If these are all a "yes", then the drug is most probably working very well.  We would still recommend getting an xray of the hands and feet every 1-2  years, though, as you suggest, just to make sure that no significant damage is occurring.