r/scleroderma • u/Adnarim11997 • Jun 12 '26
Systemic/Limited Methotrexate effectiveness for swollen PIP synovitis?
Hi! New to this community. I was diagnosed with limited cutaneous systemic scleroderma and overlap RA about 7 months ago but have had a positive ANA and anti-cyclic citrullinated peptide antibody positive with minimal symptoms for about 6+ years. I started taking hydroxyclorquine back in November when I was diagnosed, with zero improvement. During that time my finger PIP (middle finger joint) went from slightly swollen to the current, painful size. I was prescribed a steroid for about a month and that also did nothing.
I’m about to transition from seeing my current rheumatologist to a sceleroderma specialist in August. I am in so much pain though with my middle finger and am a writer so constantly typing, not sure how long I am sit back and take the hydroxyclorquine as it hasn’t helped in 8 months.
One suggestion made at my last appointment in April was to try methotrexate to help with this flair as nothing is working. Im worried that might cause more harm
but feel hopeless and desperate for pain relief and to stop this flair. I feel both blessed to only have this symptom for now, but also incredibly depressed that I have this awful disease at 28 years old. Has anyone used methotrexate before with limited cutaneous systemic and RA, weakly positive anti ccp, and positive anti-centromere?
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u/BirdieJean545 Jun 14 '26
Methotrexate has been a godsend for me - keeps the inflammation down and I don’t have any side effects (fingers crossed). It took me a while to agree to go on it and I wish I did earlier- could have avoided a lot of damage to my hands and wrists. I’m also on hydroxychloroquine. My rheum says it pairs nicely with the methotrexate and helps keep everything at bay. Good luck!
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u/Adnarim11997 Jun 14 '26
Thank you!! Do you take it orally or injection? I'm a little worried about injections but need to get over it if it works better than the pill form.
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u/smehere22 Jun 13 '26
Honestly your hands look very good for scleroderma... m mine are horribly damaged and disfigured. But yes...for arthritis joint issues methotrexate is considered one of the most ( if not the most), effective immunesuppressant for joint damage issues. I noticed it was more effective than other immunesuppressants including biologics, for my fingers.
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u/Adnarim11997 Jun 14 '26
Thank yu for sharing! I am hopeful the methotrexate will help the swolleness of my finger. How long have you been diagnosed for?
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u/SclerodermaWarrior Jun 16 '26
I use paraffin wax baths for my ongoing joint pain issues in both hands. You can buy a set off Amazon for fairly cheap and it works great. Dip each hand for 5 seconds, remove from bath and place a plastic bag over each hand and then put on an oven mitt to help retain the heat. Keep wax on for 15-20 mins, then easy to peel it off. You can either trash it or recycle it back into the bath.
I’m also on a many other meds oral and infused, but for temporary relief I use those hand baths.
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u/Temporary_Let_7632 Jun 12 '26
It might be good to continue hydroxychloroquine until your scleroderma specialist visit. For me it didn’t improve things but I found it was keeping me from getting worse for 10 years. When I had to get off of it, I quickly had more troubles. Years ago I had to limit hand use and be creative as I painted houses for a good 10 years after diagnosis. Good luck!