Rheumatoid Arthritis with Cerebral Palsy
Question: I am a 41-year-old female with severe quadriplegic cerebral palsy. The spasticity is being treated with Xanax, as Dantrium caused immediate and severe hepatitis. Two years ago, I was also diagnosed with rheumatoid arthritis. NSAIDs and Prednisone alone were ineffective, so disease-modifying agents were added. I first tried Cuprimine, which helped for a time, then stopped helping. I then tried one of the anti-malarial drugs, which did not help and caused disturbances in my vision. For the past year, I have been taking oral Methotrexate (2.5 mg 3 times a week), Deltasone (5 mg daily), and NSAIDs like Relafen and Daypro. The rheumatoid arthritis is progressing, both in severity and in the number of joints affected. I'm having increased difficulty even transferring to and from my wheelchair. I'm also having increasing problems with pain and fatigue.

Answer: Actually, the sequence of drugs is the usual one we try with Rheumatoid Arthritis. Other than advance the dosage of methotrexate you face increasingly more toxic drugs. Some people have tried Cytoxan or Immuran-- both initially anti-cancer drugs like methotrexate. You might want to get a second opinion from a national level figure. Your rheumatologist can arrange this consultation.

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