Seronegative

How do people with seronegative RA know if your medicine is actually slowing down the disease (bone erosion etc…) Dr’s put you on combos of meds like methotrexate & others to control inflammation & pain. Lots of seronegative people have no markers with bloodwork, but can have all the same pain & stiffness minus the nodules & deformities. So if the combination of medicines (methotrexate, Lyrica, celebrex, tramadol etc.) make life bearable with pain & inflammation, how do you know if the methotrexate is effective enough in slowing down the disease progression.