Methotrexate ?

[Rajuguide]

My wife suffering from gca from last 9 months , started 60 mg prednisone tapering dose , at present on 10 mg , she got 2 time flare ,when try to move 9 mg . So she had to move back to 40 mg for short course Dr told he will try methotrexate, with prednisone 10 mg for 3 months . Does methotrexate work on GCA ? pl share if anyone have any idea . 🙏

[SheffieldJane]

There is some information on Methotrexate in FAQs on here. It is used as a steroid sparer to reduce the steroid burden on the body. It would not however, protect your eyesight or the Aorta in GCA. Some people find that it supports them while tapering down from Prednisalone. My Rheumatologist is very keen on it ( I have GCA) and has been recommending it to me for years. It has side effects of its own and needs to be considered carefully. Your wife has got down to 10 mgs very quickly in my view. How is she?

[Rajuguide in reply to SheffieldJane]

My wife still struggling, up and down from last 10 months along with side effect of steriod She is in touch with team of rehumotologist , neurologist and neuro- opthologist, monthly follow up and , they response immediately . Still no permanent relief .That mean ,you also require luck to get out of GCAThanks 🙏

[SheffieldJane in reply to Rajuguide]

Also gentle, slow drops of 10% will help to stabilise this. After 5 mgs, she may want to add the expertise of an Endocrinologist. Has she been offered Actemra/ Tocilizumab? To act as a steroid sparer. This might help to reduce her steroid burden.

[PMRpro Ambassador]

Rajuguide - we have told you all we can about options for GCA and much of the information you seek is in the FAQs or your past posts.

Your wife has been on Actemra/tocilizumab and we have also told you that about half of patients on Actemra are only able to reduce their pred dose, often at about 9 or 10mg because there are other causes of the inflammation in GCA besides the one Actemra targets. Many rheumatologists are using methotrexate either alongside Actemra or instead of it once the patient stops the Actemra. It is sometimes used in GCA and sometimes it works. However, you have to try it to find out. Just because it works for one person doesn't mean it will work for another - and vice versa.

And really, to be at 10mg in the time she has taken is not bad at all - the Actemra will have achieved that.

[Rajuguide in reply to PMRpro]

I really appreciate your deep knowledge and your straight forward advice .Thanks 🙏