been on prednisolone for over 2 years only down to 8mg and consultant wants to start me on methotrexate, please advise on methotrexate

[guineapig]

I am 44 have fibromyalgia etc, consultant thought I had polymyalgia rheumatic but now thinks I have inflammatory arthritis that is not showing in blood tests, both hands, wrists, feet, ankles, hips, badly affected, I would welcome your experiences as I am new to this group thanks

[suzy1959]

I am 54 and have had PMR for 18 months. I have been up and down from 15 to 9mgs. Everytime I get below 11, I have a flare- have just been having one and gone back up to 15 yet again. My Rheumy put me on Methotrexate in June and it takes about 2-3 months to kick in. My inflammation( which does show up in blood tests) did go down briefly in August, but was back up again in September,and even further up now. This makes me think that it hasn't worked at all to lower the inflammation and so I will be asking this week to come off it. I think it has made me more tired as well. I don't know if there are any numbers for how likely it is that Meth. will work to reduce the inflammation for PMR sufferers. It is the treatment of choice for Rheumatoid Arthritis, however. You say that your consultant doesn't think you have PMR and yet, you can't come down on the steroids, which is strange because I thought it is only PMR and GCA sufferers who need steroids anyway.

It is so frustrating that our so-called experts don't really know enough to give solid advice on treatment, or even reliable diagnoses.

[guineapig in reply to suzy1959]

Thanks for replying Suzy, hope your having a good day x. I have read that meth can make you feel ill for a couple of days after you take it and I have had lung function tests because consultant said it can damage your lungs, I am seeing him again in January because he said I can't stay on steroids and will have to try another drug if I am not suitable for meth, I think its just trial and error because he doesn't really know it really is frustrating

[polkadotcom]

Methotrexate is the gold standard treatment for inflammatory arthritis and I know of several instances where PMR has morphed into one of the inflammatory types. In any case, it is quite possible to have both PMR and an inflammatory arthritis, just as some arthritis patients can have more than one type.

Your Rheumy has possibly put you on Meth as it should have some effect on the arthritis and hopefully enable you to reduce the steroid dose. It does take some time to have any effect (took 10 weeks for me) and you need to be aware that the treatments for arthritis of this type are intended to slow down or avoid joint damage, not provide pain relief, although sometimes the inflammation in the joints is slowed down enough to give some relief from the pain. Generally though, pain relief is a different deal altogether and usually depends on your individual situation.

Incidentally, Prednisolone is used across the board for arthritic conditions although they do like to keep the treatments short, but it isn't always possible to do so and there are plenty of other conditions where steroids are used long term.

[Whittlesey]

A few months after my initial diagnosis of GCA, my doctor prescribed methotextrate as a "steroid sparing agent". I take 5 pills a week, (each 4mg). I am on a maintenance dose of medrol of 5 mg a day. I believe the methotextrate does help with the GCA and helps in keeping me on the 5mg per day. I have been diagnosed w/ Cushingoid syndrome due to the high doses of medrol I have taken, for flares. Methotextrate seems to help in keeping the daily dosage of medrol low. -- --- A biopsy of a lesser used temporal artery can specifically determine Giant Cell Arteritis or temporal arteritis, if there is a question. wishing all of us health, survival and long life, Whittlesey, (U.S.)

[Polywotsit PMRGCAuk team member]

Hi guineapig. Welcome to the community. Have you joined the forum for NRAS, the rheumatoid arthritis society? Because of your age and condition, the members there will be able to help you.

[jolaine75]

Dear Kate,

I hope that you wont mind me writing to you, but I was told this summer that I had PMR and prescribed Prednislone,but because my level has dropped down from 33 to 8 my GP said that I should reduce the Preds now from 15 mg to 12 and half for this week and 10 from next week, and then reduce again on following weeks.

I was told that I am too old to have Fib

I told the GP that my pains are returning, and he said take Paracetamol

Irene