Tom was admitted for intravenous methylprednisolone to help induce remission and started on methotrexate. He was discharged home on a tapering regime of oral corticosteroids. As an inpatient he met the MDT and also had his first eye screening appointment. He had physiotherapy as an outpatient to optimise joint range of movement and recovery of function. He and his family required ongoing education and support after his discharge and he was reviewed in the clinic to assess progress and have his blood tests taken after starting methotrexate.
He had a marked improvement over the next six months in terms of his energy and mobility but had a further flare in his arthritis when the corticosteroids were tapered. He was started on a biologic therapy along with his methotrexate.
Over the next 4 weeks his family observed that he was much happier in himself and at clinic review, he had much less joint swelling with improvement in range of joint movement. His muscle bulk slowly improved over the next 8 months. He was able to stop oral corticosteroids and remained on his regular biologic (Etanercept) given by subcutaneous injections twice a week along with methotrexate by weekly injection and folic acid.