Thank you so much for your response and all the information. I actually started at 40 mg from my GP. When the rheumatologist found that out, she immediately put me on 20mg. I thought the prescription was 20 mg a pill, but it was only 10mg. So, dummy me was only taking 10 mg a day. The 40 mg helped my pain immediately. The 10 mg kept the pain away also. I live in the USA. I spent an evening in the ER because it caused terrible eye pain and tearing problems. I saw an ophthalmologist and I guess I am tearing a layer off my retina when I sleep so now, I use daily drops and ointment at night. My flare-up is really affecting my shoulders and starting into my hips. I had blood work done on Tuesday and my markers are still elevated. I am kind of disappointed that my rheumatologist hasn't gotten back to me yet, I had bad osteoporosis that I finally got back to osteopenia so being on steroids is a big problem for me. My osteoporosis was so advanced that the neurosurgeon wasn't sure I was a candidate for a double fusion. I'm not sure about a clinical trial. With my luck, I would get the placebo. LOL I guess I need to get back in contact with my rheumatologist again. I don't think I'm a candidate for methotrexate because I take Prilosec and have an ulcer. I really appreciate all your input.