I was on Plaquenil for almost 20 years, but ended up with retinal damage. Nothing else seemed to work very well, so was put on methotrexate. Worked much better, but kept having breakthrough flares. My rheumatologist added sulfasalazine, and the two together have made a huge difference. Now, I may only flare every few years!..It has been a godsend. I also take folic acid to help manage side effect. Even my kidney function improved. Just a thought.