Methotrexate withdrawal

[Austin7]

As there is little or no advice from the nhs at the moment then the only recourse is this forum, so as many of you were started on mtx at high doses of pred as a sparing agent then as you, in some cases , successfully reduced to around 2 mg and less of pred at what stage did you reduce mtx from 20mg mtx to zero and did you stop suddenly or with a taper. Is mtx entirely necessary at this stage anyway. All thoughts are great fully received as there is very little information on the internet. Cheers

[MrsNails]

As l’ve never been lucky enough to get low enough on the Pred so l don’t have any personal experience but from what l’ve read some Patients remain on MTX 6months or longer after the Pred is stopped to prevent a rebound effect, l’ll have a little search & see if l can find any Posts that may help.

MrsN

Have a look at this

healthunlocked.com/pmrgcauk...

[PMRpro Ambassador]

As far as I can gather it depends on the rheumy. Some stop it once the patient is off pred if they get that far - many don't. Others continue it for some time and either stop or taper it too.

[Katiecatweazel]

Hello, I'm reporting a different angle with Methotrexate. I have tapered down to 2mg Prednisolone, am on the Biologic Tocilizumab. My R is starting me on 10mg Methotrexate/folic acid from next week, rising to 15mg if there are no adverse liver effects. The aim is to keep me on MTX for 6 months to a year to cover the period when TCZ ends in November. She seems happy to leave me on 2mg Pred at least for a while. Best wishes

[dancersize2]

I had got down to 1mg pred and 20 MTX end of July when I saw the rheumy and asked her that very question. She said stay on 20 MTX until pred is zero then we'll taper the MTX. Next appt is Jan 2021. I did try reducing the MTX to 15 once I got to 1/2mg pred but have now had a flare so back up to 2mg to settle it down and back to 20mg MTX in case that caused the problem. Hoping the warmer weather will help (we are coming in to Spring) as I also have oesteoarthritis and I usually try panadol in case that is the problem before upping the pred.

This probably doesn't answer your question. I'll continue to post as the journey continues.