Methotrexate

[SQQQ]

I would be very grateful if people could tell me about their experiences of moving from prednisolone to methotrexate.

Thank you.

[MrsNails]

It’s not usually a move from Prednisolone to Methotrexate (MTX) but adding in MTX as a ‘Steroid Sparer’ there are quite a few of us take MTX as well as Pred but not instead of....

Is this what has been suggested?

MrsN

[Marijo1951]

As Mrs Nails said it's usually MTX as well as pred to help the pred work more effectively. I started MTX when I couldn't reduce from 25 mg of pred without a major flare up of GCA symptoms. At present I take 6.5 mg pred per day and 15 mg MTX per week.

[piglette]

Why do you think methotrexate is a substitute for pred? It is usually used with pred as a steroid sparer.

[PMRpro Ambassador]

Have you been told that methotrexate (mtx) is a replacement for prednisolone? That isn't true if what you have is PMR - it may be if they think it is some form of inflammatory arthritis.

The mainstay of management of PMR is corticosteroids - the only role for mtx in PMR is possibly as a so-called steroid sparer. Taking the two together sometimes means that the effect of the pred is increased for the same dose which means you may be able to manage on a lower dose of pred but get the same symptom relief. Unfortunately, it increasing the efficacy of pred may also mean it increases the side effects of pred - which is what it did for me. And there are no guarantees - you might get to a few mg pred less but you are unlikely to get off pred altogether by using it IF it is PMR you have.