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First-line treatment typically involves: Methotrexate the most commonly prescribed conventional synthetic DMARD Sulfasalazine or hydroxychloroquine alternative or combination options Leflunomide for patients who cannot tolerate methotrexate These medications are usually combined with short-term corticosteroids (such as prednisolone) to provide rapid symptom relief whilst DMARDs take effect, which can take several weeks to months

Whitney Hovenic, MD, is a double board-certified dermatologist and Mohs Surgeon, and co-founder of sunscreen brand SPOOGE

Most patients achieve significant results in 6-12 months

Your provider will recommend the right combination based on your specific needs

Perhaps the patients liver enzymes spiked, or they experienced severe nausea or their insurer refused to cover further refills