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Q:

Anne from Calgary asks: I have recently been diagnosed with rheumatoid arthritis.  I also have a lung disease.   I was started on hydroxychloroquine, but shouldn’t I be on methotrexate?

With some types of lung disease, rheumatologists may be cautious using certain typical rheumatoid arthritis medications, particularly methotrexate.  One of the rare side effects of methotrexate is to cause lung damage, something in particular to be avoided in an a patient with bad lungs in the first place.  Fortunately, there are many other good options available to treat rheumatoid arthritis which are relatively safer from a lung point of view.  Hydroxychloroquine is one of these options.  In mild cases of rheumatoid arthritis, this may be an excellent option.  For moderate to severe cases, further discussion with a rheumatologist should lead to an optimal treatment plan.



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