Methotrexate

[tomh]

This is my 2nd post. Briefly - Diagnosed with GCA 4yrs ago, 4 relapses (1 -7mg pred,). Moved to Brasil one year ago. Saw a new Dr last week, with working knowledge of GCA ( ie: has had patients). Last relapse was 5 months ago, returned to 20mg/d, and decreased by 2.5mg/d/month. Am now on 12.5mg. He has advised me to take 10mg/d pred, and a weekly dose of 20mg meth., taken once a week, half am and other half at night. Has advised not to drink alcohol 2 days prior and after taking dose. My understanding is that the meth. acts by making the pred. more effective, and thus enabling a quicker reduction in pred? He also advised Folic Acid.

I have read posts with side affects of mouth ulcers ( which the Folic Acid is supposed to prevent), and hair loss.

Has anyone experience of taking Meth., and it's efficacy.

I am male, 69 yrs young.

Regards to all

[Celtic PMRGCAuk volunteer]

Tom, the MTX doesn't exactly "make the pred more effective", rather it is a steroid-sparing agent which it is hoped will allow you to reduce the steroids more easily. There are several people discussing MTX on another thread today - perhaps you would like to take a look - it is under the heading 'The Methotrexate Experiment' posted by Saxjody.

[PMRpro Ambassador in reply to Celtic]

Suppose it depends how you look at it Celtic - the mtx changes the metabolism of the pred in some way and it is claimed you get the same effect from a lower dose of pred. Or, it makes the pred more effective.

[Celtic PMRGCAuk volunteer in reply to PMRpro]

As both Pred and MTX each reduce the activity of the immune system, is that extra immune suppression the reason that it works in some cases to better control the inflammation thereby allowing the Pred to be reduced more easily? If you know what I mean.....well I know what I mean anyway!!!!!!

[PMRpro Ambassador in reply to Celtic]

It could be - and yes I do know what you mean! But there are an awful lot of immunosuppressants out there, they don't suggest the others and the odd attempt with the others doesn't seem to have made much difference.

I have yet to be convinced - it's the inflammation that needs managing and I don't think the pred or the MTX make any significant difference to the immune system problem. The pred acts too quickly and the MTX doesn't necessarily have the right mechanism of action. But equally - there may be differing causes of the inflammation and that is why different groups react in various ways and over longer periods of time.

[Hidden]

This topic has been discussed at times. PMRpro was able to mention one drug (other than Pred) which has been known to work but alas! My memory issue....