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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 spondylitispsoriatic 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!

This answer was provided by Dr Philip Helliwell for the Autumn 2008 edition of our magazine, Arthritis Today, and was correct at the time of publication.

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