I tried all and predesone was the help for my inflammation..I stopped methotrexate for a short time while using Actemra but pain returned..so now weekly injection of Actemra and 20 ml of methotrexate seems to hold it. After spending days in hospital with excruciating pain now finally am sort of back to normal. In Australia you need to be 6 months on predesone and methotrexate before you are allowed biological.