Methotrexate sensitivity

[Noni71]

I found out this morning that I seem to have a sensitivity to Methotrexate. My liver function test result is 60 and after a break from the drug, it was 23. This has happened twice before. The rheumatology nurse says to miss my dose on Thursday and she will get back to me with a plan after speaking to the consultant. Has anyone else on here had a sensitivity to Methotrexate? What was an alternative plan? I also have many side effects to Prednisolone! I’m on 5mg at the mo and Tocilizumab injection once a week. Feeling a bit deflated by this news.

[PMRpro Ambassador]

Personally, if I were on TCZ and methotrexate and the MTX was doing that to me, I would say no thanks. TCZ and MTX are used together in RA, it was NOT trialed in GCA, just TCZ alone. There is no real justification for using both together.

[Noni71 in reply to PMRpro]

Thank you so much for your thoughts on the subject.

[WaltzG]

As PMRpro says my consultant told me that MTX and TCZ not essential to be taken together its just a preference if can be .....

[Noni71 in reply to WaltzG]

Thank you for that. The rheumatology nurse phoned me back again this morning after having spoken to the consultant. He is keen to try an even lower dose of Methotrexate to see if I can tolerate that. This is because of my side effects to the Prednisolone that I’m not keen on getting again!

[Sharitone]

I was on both MTX and TCZ for a while, but as MTX was doing nothing but making it difficult to hold on to my hair, it was stopped. I was so pleased!

[Noni71 in reply to Sharitone]

Oh no! I would hate that! I have no physical side effects that I am conscious of but clearly my body doesn’t like it particularly my liver!

[Dressage_Diva]

Methotrexate injections made me feel very ill, Tocilizumab enabled me to come off prednisone completely after a few months and when I was just on the TCZ I felt back to normal and because it’s a biologic, the only side effect was raised cholesterol which I took a statin to control. I had my funding extended at the time because of the pandemic and was lucky to be on it for almost 2 years.

When it stopped I was fine for 4 months then had a flare up and can’t get funding any more so I’m back on tapering prednisone with Mycophenolate. I don’t feel great and the fatigue is back but my rheumatologist is trying to get me back on tocilizumab and I’m praying she succeeds. Don’t be deflated be joyful - take it whilst you can, it’s amazing stuff!

Good luck xx

[Noni71 in reply to Dressage_Diva]

Good to hear that Tocilizumab made all the difference to you. As soon as I stop taking the methotrexate then my original symptoms return so the rheumatologist is trying not to increase the Prednisolone as the side effects were not good for me! Hope all goes well for you! X