Link with Polymyalgia and GCA

[christine2715]

I am diagnosed with GCA and I wondered it that means that when I start to cut down on the Predisilone will I also get Polymyalgia? I am due to be prescribed Metatrixate - is that to prevent getting Polymyalgia?

[piglette]

Hi Christine. Just because you have GCA does not mean that you will get PMR too although it is possible and vice versa. The Methotrexate is supposed to help you reduce the steroids more easily. Some people think it helps, others are not so sure. Good luck.

[Celtic PMRGCAuk volunteer]

Christine, I'm sorry to hear that you have been diagnosed with GCA, but can reassure you that cutting down the steroid dose does not mean that you "will also get Polymyalgia".

I know many people who have been diagnosed with GCA and have gone into remission without succumbing to PMR.

It is true that having either PMR or GCA can predispose someone to the other condition, and up to 50% of those with GCA do develop PMR, but it is certainly not a given.

Methotrexate is a steroid-sparing drug and is usually only prescribed when someone is continuously unable to reduce from the higher doses without their symptoms returning. I think there is very scant evidence that it works in GCA - in fact I was at a vasculitis symposium last year where it was described as being "poorly tolerated". There has recently been a very large study carried out on another drug, Toxilizumab, in the treatment of GCA but although the trial is completed there are no results published yet.

I hope that helps to reassure you - meanwhile, if you haven't already read it there is an excellent book available called 'Polymyalgia Rheumatica and Giant Cell Arteritis: a survival guide' written by Dr Kate Gilbert, and available direct from Amazon or from PMRGCAuk, pmrgcauk.com, with all royalties from the sale being donated to the Charity.

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[PMRpro Ambassador]

Some people develop PMR symptoms as an expression of where their GCA is affecting - just like some patients have headache, others have jaw pain and some have neither. You may develop some PMR-type pain but not necessarily at all and there is no way of knowing in advance.

Methotrexate sometimes makes the pred work more effectively so you can manage on a lower dose of pred. It also has its own set of side effects and if you suffer badly with any of them don't be afraid to tell your doctor - if it helps and you feel OK that is good but if it adds to your miseries it isn't and possibly not worth taking and suffering. But most people take it and have no problems at all.