having been dismissed as to young for pmr even though i have all the symptoms the rhumatologist has prescribed methotrexate for inflamatory arthritis but having done alot of research am i right in thinking its only to be used when all other treatments havent worked and it looks like predisone can be prescribed for both illlness,s , I have made to decision to refuse to go down this road and ask for predisone.
I havent been on any treatment yet apart from nurofen since march apart from a steroid injection depo medrol whic h was inaffective after 1 week.
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snoopy29
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Not really - methotrexate is the first line approach for several forms of inflammatory arthritis. It is a disease modifying anti-rheumatic drug that reduces the potential joint damage - pred doesn't do that.
Since over 50 is the age criterion for (most) PMR it's a bit steep saying a 49-year-old is too young. In the UK, NICE now says over 40. Maybe a second opinion? Methotrexate is likely to take months to show an effect even for an inflammatory arthritis so you won't find him changing his mind because it doesn't work for you.
Some rheumies think that mtx will reduce the amount of pred required in PMR and it does for some patients - see MrsNails story. But really it does all depend very much on the correctness of the diagnosis in the first place. He's not prepared to consider a PET-CT which would show if it could be PMR?
I have a gp phone app on thurs and have a list of questions for her and will just see how we get on, read through Mrs nails post and found it very helpful thanks.
I have had pmr for 4 years. I am still at 15 mgs. My dr. wanted me on methotrexate in the very beginning. I refused it and am sorry I did. After about 2 years I finally decided to try it as the pred. was causing me so much trouble. I was not able to tolerate the metho. and went off of it. I have tried 4 different dmards and can't tolerate any of them. Personally, I think if I had tried the metho. from the start, before I got so worn out from it all, I might have had a chance at succeeding with it.
I am at the point where I just can't stand one more side effect.
Thank you for your input , just very apprehensive about taking it at all, my theory is why not try prednisone first then we will know that it is pmr and if it doesn't work then rethink on the methotrexate, if I thought it would help on it's own for pmr then I would give it a shot , cheers and wishing you well ,
I have only had methotrexate x2 doses at 7.5mg (weekly injections). My CRP is going back up not down (started to wean off prednisone) and now I have to increase my dose to 10mg weekly. MD says that if my CRP levels do not start going down she might have to reconsider Methotrexate and start with something different. I was hesitant at first on the Methotrexate...but have had a lot of acquaintances tell me they take it and it takes away the inflammatory pain. Try it. I might have been premature and anxious about taking Methotrexate. Best of luck.
Methotrexate can take up to 12weeks to become fully active & you have only had two weeks on a trial dose, they always start you lower to ensure you can tolerate it.
How much have you dropped your Prednisolone? I dropped mine by 1mg monthly once l was on 20mg of Methotrexate until l reached 9mg & from there on by 0.5mg to 7.5mg.
Maybe your Consultant is expecting a bit too much too soon?
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