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If you arent responding to methotrexate after a two-month period, your rheumatologist may try some kind of combination therapy, such as adding sulfasalazine and hydroxychloroquine (called triple therapy) or adding a biologic drug such as etanercept (Enbrel), adalimumab (Humira), or infliximab (Remicade)

Documented total vitamin B12 levels less than 250 pmol/L within the past three months

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In some cases, supplementing one B vitamin (such as B7 or folate) can help mask the symptoms of a different deficiency (such as B12 or cyanocobalamin), but it doesnt completely erase the damage