Methotrexate. To have or not to have? That is the... - PMRGCAuk

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Methotrexate. To have or not to have? That is the question.

susanspurs profile image
31 Replies

Hello Wise Ones

I was diagnosed in May 2013 with PMR aged 67. I’m a-typical and scans ruled out anything else and I responded really well to 20mg of steroids. I could fly and had boundless energy.

Over the years I’ve had flares but I’ve settled on 5mg Prednisolone for the last couple of years but it isn’t enough really but the steroids have had a dreadful effect on my skin. It’s now paper thin on my shins and arms and I’m rarely without a leg ulcer. I’m also black and blue on my arms and legs and some of the staining from the bruising is permanent. I’ve had other steroid related problems as well - insomnia, hair loss, vision problems, high BP, numbness in fingers and toes, brain fog, etc etc. Bones ok though.

So I’ve been resisting Methotrexate and I won’t up the Prednisolone permanently. I do up it for a few days when I’m bad. Think doctors are fed up with me and I suppose it’s mutual. Rheumy dismissed Leflunomide although I don’t really want to take that either. I have a complicated medical history and am on eight other medications and I really don’t want any more drugs!

I think there was a link to a study on Methotrexate and PMR that someone posted maybe a couple of months ago but I can’t find it. I recall that the results weren’t good. I’d like to show it to my rheumy who sings it praises (they are very used to prescribing it for rheumatoid arthritis).

Hope someone can recall the link.

Susanspurs

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31 Replies
DorsetLady profile image
DorsetLadyPMRGCAuk volunteer

Hi,

This subject comes up quite a lot, and I guess you’ve typed METHOTEXTRATE into search box - probably got too many links!

Is it possibly this from MrsNails -

healthunlocked.com/pmrgcauk...

susanspurs profile image
susanspurs in reply to DorsetLady

Dear DorsetLady

That’s a very interesting thread which I have read. It was a particular link to a recent study on PMR and Methotrexate that I was after. It had rather negative results and that’s what I want to show my rheumy to support my case for not taking it. Susanspurs

in reply to susanspurs

Can you remember how long ago the article was referenced in here?

susanspurs profile image
susanspurs in reply to

A couple of months ago I think.

in reply to susanspurs

The only thing I can find that "negative" is this thread regarding an FDA warning the the USA. It's not a study in relation to pmr. Someone may be able to come up with it later.

Try double base gel for your skin...it's helped mine. I am on a steroid sparer, mycophenolate, and they all come with warnings but some people are ok on them and others not on a range of steroid sparers. If I had got to 5mg without I would be happy. Good luck..

healthunlocked.com/pmrgcauk....

susanspurs profile image
susanspurs in reply to

Tried every cream on the market (seen a skin specialist) and try to moisturise shins and arms at least twice a day. I like bio oil and some of the gel moisturisers but they leave the skin very shiny. Trouble is I have to be so careful as just doing that can break the skin. I’m 73 and my skin looks like I’m 100! Lucky face ok so far - touch wood. I like double base on my face.

in reply to susanspurs

That's sounds very sore, I will keep my fingers crossed you don't get bad tears. 🌻

susanspurs profile image
susanspurs in reply to

🙏🏾

susanspurs profile image
susanspurs in reply to

I first read it is 😭. It does make me cry sometimes 😀

in reply to susanspurs

I know...I kept looking at it to see if there was another word but they are tears usually. But am ok it has a double meaning..but not that it can make you cry. 😟

susanspurs profile image
susanspurs in reply to

Funny. Tears make tears!

HeronNS profile image
HeronNS in reply to susanspurs

I did see somewhere that it's worth asking doctor whether retinol may help thin skin. This item mentions it: mayoclinic.org/healthy-life...

susanspurs profile image
susanspurs in reply to HeronNS

Thanks. I haven’t heard of retinol. I’ll ask my doctor if I can give it a try.

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply to susanspurs

Sorry can’t help. Hopefully someone who is on MTX might remember it - which is why I suggested MrsNails’ post.

bakingD profile image
bakingD

Hi there

It sounds like you are getting steroid related side effects but the next choice of drug can be difficult to know what’s best- a very good Rheumatica with an interest in PMR whom I saw a few months ago would put Leflunomide first before Methotrexate- it’s all a bit difficult to know what is best

Hi

I can't find one you mention but PMRpro is the most likely to know, however, she is travelling at this time, how soon do you need this information?

Thanks MrsN

susanspurs profile image
susanspurs in reply to

Well really there's no rush. It’s up to me. I’ve spent hours searching through the threads and on google. Have found some studies on google but I’m wondering if I imagined the one I’m looking for.

in reply to susanspurs

I can’t find anything at the moment but if l do, l’ll let you know.

I’m waiting to go back on it! 🙏🏼

susanspurs profile image
susanspurs in reply to

Thank you 😊

Suet3942 profile image
Suet3942 in reply to susanspurs

Have a look at my threads. I've been on Mx for about 3 years. Did try to come off it but had such a bad flare. Back on 17.5 a week.

in reply to Suet3942

Sue

What does of Pred are you on now? x

susanspurs profile image
susanspurs in reply to

I got it down from 20mg to 5mg in about 3 years. For the last 2 years or so I’ve been in 5mg going up to 10/15 for short bursts when I’m really struggling. Can get below 5mg.

Suet3942 profile image
Suet3942 in reply to

Hi Angela. I’m on 9mg. Having real trouble reducing.

in reply to Suet3942

I’m on 12.5mg & hoping to resume Methotrexate when l see the Consultant. Just been to have my Bloods done do he’ll have a clearer picture when l see him.

Take Care

Angela x

susanspurs profile image
susanspurs in reply to

Angela I gather bloods have to be taken every couple of weeks particularly to check the liver function while on MTX. Good luck with going back on.

Sue

in reply to susanspurs

Yes every two weeks for the first month/6weeks then after that monthly & ideally GP’s are not allowed to issue repeat prescription unless blood test have been taken.

I had mine done today, so l’d be head of the game when l see DrD on 27/8

susanspurs profile image
susanspurs in reply to

Good luck with your forthcoming appointment.

Suet3942 profile image
Suet3942 in reply to

Hope all goes well. Xx

susanspurs profile image
susanspurs in reply to Suet3942

Thanks Suet3942 I will look at your thread.

PMRpro profile image
PMRproAmbassador

Basically, there have been 3 small studies on the use of mtx in PMR. One decided it didn't help and one didn't know. An Italian study found it DID result in a very slightly lower cumulative dose of pred over a couple of years - but found when they followed up 5 years later that it didn't reduce the incidence of adverse effects of mtx or get people off pred quicker. So one asks - why add in another layer of adverse effects?

susanspurs profile image
susanspurs in reply to PMRpro

Thanks PMRPro for replying while you are on your travels. Why add in another layer of adverse side effects is exactly how I feel especially if there’s no real evidence to support its use. I’ve resisted MTX for two years and will carry on resisting. I will plod on with my heavy, tired legs that sometimes don’t want to move and up the steroids as and when necessary.

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