Looking for Experiences with Adalimumab (Humira or Biosimilar): Monotherapy vs. Combination Therapy

I’d appreciate hearing about your experiences with adalimumab, especially as:

  1. Monotherapy

  2. In combination with methotrexate

Background:

Diagnosis Unclear: My rheumatologist hasn’t confirmed PsA or RA, but my GP leans toward PsA due to symptoms and blood markers. Only CRP has been elevated (since January); no RF or anti-CCP.

Symptoms: Chronic synovitis in one knee for 14 months, spreading to the other knee recently. Minimal joint damage on MRI/CT/ultrasound (5 months ago), but stiffness and a calcified nodule on the first swollen knee. Lifelong body pain, possibly enthesitis in lower extremities.

Treatment History:

Sulfasalazine: Stopped due to mouth ulcers and GI issues.

Methotrexate (20mg injections): No relief after 3.5 months.

Leflunomide (7 weeks): GI issues persisted even after stopping.

Cortisone/Prednisone: Minimal and short-lived relief.

Current Treatment:

Started Adalimumab (40mg): First dose 1 week ago; slight softening of knee fluid observed.

Plan to Add Methotrexate (15mg weekly): Rheumatologist recommends combining it with adalimumab. I’ve delayed methotrexate for now to monitor adalimumab’s initial side effects.

Questions:

  1. Monotherapy: Has anyone had long-term success with adalimumab alone?

  2. Combination Therapy: Did adding methotrexate improve adalimumab’s efficacy for you?

  3. Weaning Off Methotrexate: Has anyone started with adalimumab + methotrexate and successfully transitioned to adalimumab alone while remaining stable?

I’m not seeking medical advice—just personal experiences. I know everyone’s symptoms and medication responses are different.