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Resources for LORA: Late onset rheumatoid arthritis?

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FLpanhndlKen
FLpanhndlKen

I have posted here before about my three years of PMR and its end;  the development of humeral ostronecrosis, probably related to prednisone use, and now the appearance of what appears to be Late Onset RA (LORA), which EileenH has noted is not an unusual development after PMR. My question is: are there any specific resources on patient.uk for this disorder? My PCP (an internist and gerontologist) is treating me with methotrexate and a small (5 mg) dose of prednisone, but I’m not sure what to expect, or whether I should bite the bullet and see a rheumy. Any advice appreciated ...  (btw I have had one shoulder replaced and look forward to the other in 2018, bringing my total number of faux joints to 6!)

1 like, 4 replies

4 Replies

  • EileenH
    EileenH FLpanhndlKen

    Posted

    If you have a gerontologist I'd suspect you may be OK with their ministrations - providing it IS LORA. There is a rheumatoid arthritis forum on here but it isn't as active as this one and I'm not sure it is as good as it was (I'm a member of it too). 

    In the UK definitely and for most of the USA methotrexate is the first line medication for all inflammatory arthritis of this sort. If there are definite diagnoses of other sorts (PsA for example) they may start with another drug that has been found to work better but for RA methotrexate has been the drug of choice for years so they are familiar with it and its side effects. There is no point starting with the heavy guns if methotrexate is enough - keep them in reserve as for some people a drug works for some time and then the efficacy fades or in others it simply doesn't work at all. Then you move to the second on the list. Rinse and repeat.

    It has recently been written about that a low dose of pred is a good way of managing early LORA, which doesn't seem to cause as much joint damage as other sorts or inflammatory arthritis so it seems ot me you have a good mix there. If YOU feel well on it that is what matters - and you have the mtx as the DMARD (Disease Modifying AntiRheumatic Drug) which should reduce any joint damage. 

    Out of interest - why have you had joints replaced? I'm sure you have told us but I can't remember. Was it really PMR in the past?

    • FLpanhndlKen
      FLpanhndlKen EileenH

      Posted

      No, the hips and knees went to just plain old osteoarthritis. Left hip 22 years ago (I’m now 69), and on the day in 2014 the orthopedist told me I needed a new right hip and two new knees, he also sent me to get labs because of the inflammation he saw in my X-rays, whence came my PMR diagnosis, which explained all of the symptoms I had been experiencing for months beginning with simple (and basically unpainful) crepitus in my right arm-shoulder and progressing painfully through my shoulder and hip girdles. So the shoulders are the most recent, and hopefully last joint replacements, thought my 22 year old left hip will probably need some attention someday, hopefully not soon. 
    • EileenH
      EileenH FLpanhndlKen

      Posted

      I understand the prostheses they used 22 years ago were built to last so you may be lucky!!! Plain and simple - so less to go wrong,,,
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