Predisolone and Methotrexate

[Chipola]

Has anyone with GCA been prescribed 60mg Pred daily and 15mg MTX weekly from the start? Was wondering as posts here don't mention MTX until tapering and then seem to be cautious of taking it due to side effects.

[PMRpro Ambassador]

There are doctors who think adding MTX from the start helps smooth the path of reduction and at one time there was mention that if they were going to use it in GCA, it should be used immediately. OTOH, Prof Dasgupta has expressed the opinion that he doesn't think that MTX achieves anything in GCA. You pays your money, and you takes your choice. No studies looking at it at all that I know of. I think it may have been used in mainland Europe as fairly standard but I'm not sure.

[jinasc]

Information and Tips for people with PMR and/or GCA from Professor Bhaskar Dasgupta’s talks in Cardiff and Bristol on 24 May 2019

10. In my experience Methotrexate is not as effective in treating PMR or GCA as it is for rheumatoid arthritis although some trials have shown a small beneficial effect. Leflunomide, based on open case experience, is often more effective as a steroid sparing medication for treating both GCA and PMR. We are searching for resources to conduct high quality trials with leflunomide. Such a trial in PMR is running in Netherlands.