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Crohn's Disease Forum » Treatment » Methotrexate » MTX as the only therapy?


10-25-2015, 01:53 PM   #1
rowdyirish1
 
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MTX as the only therapy?

I am currently waiting on my Humira to be approved through insurance but if it's not for some reason I'm wondering what my options are.
Is anyone being treated for CD or CD/AS with Methotrexate as the sole source of therapy? If so, was the treatment successful for one or the other or both?
10-25-2015, 03:28 PM   #2
FrozenGirl
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I'm not however I know there is people who do it. Is is usually considered a middle step by itself, The Med you try after Asa drugs but before biologics. It may be worth a shot but keep in mind it takes 8-12 weeks to be fully effective.
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Dx: Ulcerative Colitis, Nov 2013
Currently on:
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Tecta 40mg
Remicade: 600mg, every 4 weeks
Methotrexate: 15 mg (injection)
10-25-2015, 04:58 PM   #3
Clash
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With AS, it is the biologics that really changed the course of treating that disease. So the biologics were the game changer as far as AS is concenerned.

Maya142, who posted in your other thread can tell you more about that.

There are other biologics like remicade, cimzia and then even more that aren't anti tnf. It's just that with both CD and AS you have to find the med that's gonna be effective for both.
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CURRENT MEDS: MTX injections, Stelara


Dx May 2014: JSpA
8/2014 ileocecectomy
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PAST MEDS: remicade, oral mtx, humira
10-25-2015, 05:27 PM   #4
Maya142
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I already posted on the other thread about how MTX is generally not effective for axial arthritis. I know that before biologics were an option, usually Sulfasalazine and occasionally MTX were used for AS. They worked for some people, but for most, weren't very effective.

I think the only way you'll know if MTX works for both your CD and AS is if you try it. There are definitely people who use only MTX for their Crohn's and it does work for some. Unfortunately, it's all trial and error.

Like Clash said, biologics are the game changing drugs for AS and Crohn's, not MTX. They work fastest and are most effective.
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dx with JIA at 14
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10-26-2015, 11:57 AM   #5
rowdyirish1
 
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I already posted on the other thread about how MTX is generally not effective for axial arthritis. I know that before biologics were an option, usually Sulfasalazine and occasionally MTX were used for AS. They worked for some people, but for most, weren't very effective.

I think the only way you'll know if MTX works for both your CD and AS is if you try it. There are definitely people who use only MTX for their Crohn's and it does work for some. Unfortunately, it's all trial and error.

Like Clash said, biologics are the game changing drugs for AS and Crohn's, not MTX. They work fastest and are most effective.
The reason I'm asking is that I'm having a tough time getting the Humira approved through my insurance.
I'm thinking long term here...
Not so much about relief but more along the lines of what to expect 6 months from now if MTX is the only treatment I can get approved.
The insurance company pretty much gets to decide how soon I feel any real relief!
10-26-2015, 01:22 PM   #6
Clash
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Is your doctor fighting the insurance company. I would stay on top of it and make sure the doc sends corroborated notes and letters for both illnesses. Also, I'd call the 8nsurance company and ask for a case manager.

I would have expected letters sent from both the GI for CD and the rheumatologist for AS.

There are companies thathat would rather you try humira before they pay for remicade but I haven't heard of a company that wanted the opposite. Still, I stay on top of the reasons they were giving.

Good luck.

A lot of meds like mtx or the other Maya mentioned may or may not help with symptoms but it is the biologics like humira that have cut down on the need for surgeries for AS.

Hope it all works out.
10-26-2015, 04:21 PM   #7
Maya142
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I would have your rheumatologist talk to your insurance company -- generally for AS, docs try NSAIDs and if those fail (or can't be taken for some reason), then they jump straight to biologics, since MTX has not been shown to be very effective in AS.

Sometimes insurances require you to try and fail MTX/Sulfasalazine before going on to biologics (it's called "step" or "step up" therapy sometimes), so in that case, you'd try MTX and if it worked, great and if it didn't, you could go on to Humira. So don't worry - even if you have to take MTX now, that doesn't mean you'll have to take it forever if it doesn't do enough for you.
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