Methotrexate

[yorkieme]

Good afternoon ladies and gents' I hope you are all as well as can be while enjoying the lovely weather.

I wonder if once again some of you might be king enough to throw out a few things for me to think about. I had my appointment yesterday with my rheumy who told me quite some time ago that; a,) Due to a systemic inflammatory problem as yet unidentified,two visits to the Covirad unit,pneumonia and non Hodgkins lymphatic cancer my case apparently isn't an easy one. b,) I now take morphine 24/7 due to crushed T4 and damage to T5-T7. c,) She believes the initial high dose steroid,60mg, caused some damage. Doesn't say what.

She has now put me on 15mg MXT,tests every two weeks etc,Dexa scan on Thursday with the intent of either bringing me off Pred' or running it parallel to MXT.

I have read lots of opinions about this drug and have my own reservations,e,g, if I am being treated for an unknown why change from Pred' to MXT? One set of side effects in exchange for another.(I presently have five with Pred' plus appropriate medication to counteract,)

What will MXT achieve that Pred' doesn't ? I am on 20mg/day with no PMR symptom pains at the moment.I am on 100mg morphine/day so can this hide PMR pain ? I can see my situation is weird but I lack the broad based knowledge to be able to grasp the bigger picture.

All comments would be welcome because within the next day or two I have to decide.Thank you.

[Marijo1951]

I've been taking Methotrexate since December 2017, but in addition to pred, rather than as a replacement. I was first prescribed it when I couldn't reduce my pred dose below 25 mg without flaring. I'm not one of the members with extensive medical or pharmaceutical knowledge - I'm sure they'll be along - and I certainly don't have the medical complications that you suffer. However I'm pretty confident that in cases of PMR and/or GCA, MTX is always used as a steroid sparer not as a complete substitute.

[yorkieme in reply to Marijo1951]

Yes,I now understand that I will still be on Pred' at some level plus MTX. Thank you for your comment.

[jarn]

You might ask about TCZ (Tocilizamab); my rheumy did start me on MTX but she didn't think the results were as good as TCZ, after much research. Also, she wanted me off the Pred and did take both TCZ while I was tapering off Pred. Apparently exc results on my lab reports. Good luck and let us know you go. MTX is also used for cancer patients.

[MrsNails in reply to jarn]

Hi jarn

Just for Info:-

MTX is classed as a ‘Steroid Sparer’ at the dose we take it 15mg/20mg though it is in fact a DMARD (Disease Modifying Anti Rheumatic Drug) generally taken at up to 25mg for Patients with RA weekly.

When it is used as Chemotherapy it is at much considerably higher doses.

Kind regards

MrsN

[yorkieme in reply to jarn]

Thank you.

[MrsNails]

Hi Yorkie

I’m on MTX as a Steroid Sparer but at this time l am by no means able to reduce the Prednisolone like l did when l was first on it in 2014, when l was able to reduce by 1mg per month to 7.5mg from 18mg

You need to ask the Consultant to explain their thinking, l presume from the Pred Dose you started on you have GCA? How long have you been on Pred & at 20mg per day?

Pmrpro may possibly come up with some ideas & questions for you to ask your Consultant.

I would imagine the Morphine at 100mg will have some impact on your pain in general but not the stiffness.

Good Wishes

MrsN 🍀

[yorkieme in reply to MrsNails]

Initially my G.P. prescribed 15mg for PMR,after reading my medical history picked up eye problems and then increased it to 60mg on the basis of possible GCA.

I have yet to receive a definitive statement regarding what the problem actually is other than a systemic problem.

I have now been on 20mg for three weeks,was on 15mg but for some inexplicable reason one of the rheumys increased it to 20mg for test purposes,I haven't heard what the tests were or the results.

Many thanks for your response and good wishes.

Kind regards.

[Pat13]

Hi. Sounds like you’re having a difficult time. I was put on Methotrexate alongside prednisone to help with PMR and developing inflammatory arthritis. I only managed a few months on methotrexate because I had an adverse reaction and had to change to an alternative and I was put on leflunomide I am fairly stable on that although I have just (in the last 6 months) had both knees replaced and am currently waiting for surgery on my shoulders and treatment on my spine. I really struggled with methotrexate and it made me feel very unwell. Good luck

[yorkieme in reply to Pat13]

Thank you for your response.It sounds to me as though we both have plenty going on so I wish you good luck too.

[scottygirl73]

I was on this but my goodness i was so ill on it,vomiting the runs and feeling so awful even now after stopping it 2 years ago i still have problems with my stomach,now on Actemra.But we all cope with medication differently so you may be ok.Good luck.xx