Hello doctor, My mother is 65 years old. She is RA positive for the last 25 years. Currently, she takes HCQs, Methotrexate, pain killer, and Rantac. At present, she has pain, nodules in hand, and turned feet. Please suggest proper medication. Her LFT and KFT are normal.
Hi. I have gone through your query. But the report images could not reveal anything. (attachment removed to protect patient identity).   I would like to ask you a few more queries before suggesting the medicine as any new DMARD (disease-modifying antirheumatic drug) started has to be taken with caution. You mentioned pain, is it in the joints or the whole body? Is there dryness of eyes or mouth? Is the sleep normal or disturbed? Any forgetfulness? Irritability? When is the pattern of pain more, mornings after waking or constant throughout? Please message me the dose of Folitrax as well which she is taking and the name of the pain killer? Do you have the last ESR (erythrocyte sedimentation rate) and CRP (c-reactive protein)? Is she taking calcium and Vitamin D supplement? I understand she has an aggressive disease considering nodules, deformities persisting. But lot of times people with long-standing arthritis develop secondary fibromyalgia and the management is very different. We can only be 100 percent sure after clinical examination but will help you in the best possible way we can.  Try to reattach the reports as well.