I've been taking mtx for about 4-5 months now, and I must say it works well for me. My rheumy gave me the choice of mtx or arava as well, but he told me in his experience, arava doesn't work as well as mtx. I believe it simply depends on the patient--some drugs work better for others. I also have bad GI issues, but I have had surprisingly very few GI side effects from the mtx. If you experience stomach problems that can be attributed to the mtx, you can always switch to the injectable form--which will bypass the stomach. If hair loss and/or mouth ulcers start being a problem, again my rheumy said he would just up my folic acid. It took a while for the mtx to kick in, but once it did I found it works very well for me.
Current dx: Rheumatoid Arthritis
Suspected dx: UCTD/Early Lupus
Current Meds: Enbrel, Plaquenil, Aciphex, Ultracet, Zyrtec, Allavert-D, Zantac, Tylenol PM
Past Meds: Relafen, Vioxx, Mobic, Voltaren, Sulfasalazine, Entocort, Prednisone, Humira, Reglan