What is seronegative inﬂammatory arthritis and how effective is methotrexate in treating it?
Q) I've recently been diagnosed with seronegative inﬂammatory arthritis and have been put on methotrexate. Could you please tell me what seronegative inﬂammatory arthritis is, and what is the long-term prognosis? I'm 65 years of age and healthy, apart from this problem. How different is it from other forms of arthritis? How successful is methotrexate?
Vic Sibson, Broadstairs, Kent (Autumn 2008)
A) Arthritis can be generally divided into seropositive and seronegative – this refers to the presence in the blood of an antibody called rheumatoid factor. About 70 per cent of people with rheumatoid arthritis are seropositive. So seronegative rheumatoid arthritis occurs and this may be the diagnosis in your case. I say ‘may be’ because there's a group of disorders generally called ‘seronegative spondyloarthropathy’ and these include ankylosing spondylitis, psoriatic arthritis and reactive arthritis. My guess is that you haven’t got one of these conditions. Seronegative rheumatoid arthritis can be just the same as seropositive rheumatoid arthritis although on the whole it has a better outlook. If you don’t feel the doctor has the time to explain things to you, try asking to see another member of the rheumatology team – a nurse, physiotherapist or occupational therapist, or all three!