MTX QUESTION

[Darcy2000]

Been on MTX for 8 months ( 25 mgs ) once a week along with tapering Prednisone …currently at 10 of Prednisone a month with a planned taper of 1 mg a month . Question is : I have no clue as to whether the MTX addition is helping at all .I would prefer to be on as little medication as possible . My CRP is currently 9 having reduced from 11

I am seeing my Rheumatologist on January 9 th .Hoping he can justify keeping me on this med or agree to reducing or stopping all together.

Any thoughts on this ?

[PMRpro Ambassador]

How has your tapering gone before and while on MTX? Difficult to say without some context - and even then, even with uneventful tapering you can't really tell if the MTX has contributed positively to your journey. Do you have any side effects?

People have decided that the MTX wasn't helping and stopped taking it, only to have a flare - the MTX was obviously doing more than they thought.

[Darcy2000 in reply to PMRpro]

So true… hard to know for sure . I guess the only way is to give it a try if my Rheumy is agreeable .

Thanks for input

[Myfoe]

I also have been on MTX around 8-months I started at 60mg prednisone around 18months ago I started with MTX pills when I got stuck at 12mg prednisone but my stomach etc. said no way switched to weekly 25mg injections and my stomach issues subsided but soon I noticed I had what felt like crushed gravel in my shoes and some aching in wrists and ankles for two days after the injecting MTX so I cut back to 15mg and the MTX pains went away I was able to get down to 8mg prednisone but wasn’t sure it was helping much anymore Kevzara was added and I was dropped to 10mg MTX I was able to get to 3.5-4mg but I rushed to get there and had a huge flare only then could I notice a slight difference when I take weekly MTX I question if the difference is profound enough to justify taking MTX but my rhumey wants me off prednisone before MTX

[PMRpro Ambassador in reply to Myfoe]

I wouldn't accept being on pred, Kevzara AND MTX. Not given the increasing evidence MTX doesn't do much if anything in PMR. Kevzara will be much the same as Actemra - it works on IL-6 inflammation but if any other mechanisms are involved in your PMR, you will need some pred to manage it. It is well known that GCA has at least 2 other mechanisms involved in the inflammation and PMR is very likely to be the same as it is a spectrum of disease.

[MiniSpec in reply to Myfoe]

You are a GCA patient aren't you? And you said, "my rhumey wants me off prednisone before MTX ".

My response to him would be that it doesn't matter what He wants, the disease will dictate whether you can come off Pred or not. If he tries to bully you into stopping Pred ask him if he'd stop taking it if doing so could risk his eyesight, or an adrenal crisis (which can be fatal!).

If he still insists that you should get off Pred then find another rheumy, quick!

MTX may help with reducing Pred for some, but it's not a replacement for it. My understanding of it is that it's merely a helper drug. It can't protect you from blindness or adrenal crises in the way that Pred can.

[Darcy2000 in reply to Myfoe]

Thanks so much very informative

[Smithie49]

Hi. I've been on methotrexate 15 mg weekly since 1st Jan this year. I was on 6.5 mg pred. Everything I reduced the pred by 0.5 mg I had a flare. So I'm now back to 7 mg!!! My rheumy increased the methotrexate to 20 mg a few weeks ago but I haven't noticed any difference. I'm not planning on tapering yet. Good luck with your strategy 😀

[Darcy2000 in reply to Smithie49]

Thanks so much wish me luck

[GolfNana]

I don’t have any experience with Methotrexate but the 1 mg / month reduction of prednisone seems to be the golden rule around my part of the world. It seems to have worked for me.

[Darcy2000 in reply to GolfNana]

It worked fine for me til I hit 4 Mgs and then Flare so that is why the Rheumy added the MTX

[DorsetLady PMRGCAuk volunteer in reply to Darcy2000]

Don’t see the point in adding in MTX when you’re as low as 4mg..maybe try staying on each dose for longer than a month .. if you keeping stuttering at that dose.

[GolfNana in reply to Darcy2000]

Ahhh… of course.

[PMRpro Ambassador in reply to Darcy2000]

There is little point adding MTX at that dose as its potential side effects are probably worse than the pred. If you stutter at the same dose repeatedly that is telling you you have arrived at your lowest effective dose which is what you were looking for, If you stop yoyoing your dose you will probably take less pred overall and even get lower again, without MTX.

[Darcy2000 in reply to PMRpro]

8months in and hard to say if I am having side effects from the mtx .Other than the first 2 hours in the am until pred kicks in I feel very well.

Swim 60 lengths 4 times a week which keeps me flexible and my mind calmer.

I am still on this 5 year journey with PMR ,with only 2 flares and a GCA scare.

Count myself lucky I guess

[Irishfurbaby]

Hi DarcyI had/have PMR and was on Presidone only 20 mg but got off slowly within 12months. I never had MTX. Now I take Turmic and do a lot of yoga and pilates to help keep flexible as possible. I hate taking medication never feel right.

Good luck search for anything or anyone who may offer natural products or advise

Good luck