I need more information about Methotrexate please.

[Buenavista]

Hi guys,

Hope you are having a good weekend.

I need some information about Methotrexate and whether I need to be taking it.

I asked for your advice at the beginning of March about my dosage of pred, this is because I had a flare up. I followed your advice and it worked a treat. Now I need some more help about Methotrexate. On Monday I see my Spanish Rhuemy, the question I need to know is, a quote from my English rhuemy,

"I think he may be a candidate to introduce Methotrexate, on the assumption that this may be a polymyalgic presentation of Rheumatoid arthritis"

So please can you tell me more about this drug and it's side affects. I do not want to change unless I have to. I get the x-ray results on my hands at the same time on Monday. If I only have PMR, which I have had for 18 months, then I can stay on pred, better the devil I know.

Best regards

Buenavista

[2watsons]

I have been on MTX for last eight months my Rheumatolist said it would reduce pain and help reducing Predinsolone ,i am on 12 .5mg weekly ,i still have one day after taking it when

feel tried ,i loss an eye very sudden from GCR .Monitoring of blood was done very other week now each month as liver damage can happen.. Before i started MTX was talked through it and knew all the good and bad ,and i decided i had no choice in my case ,so when heard all facts that will help .The wed site has a very good site on Methtrexate .May add all blood teats fine .

Hope helps .

[Celtic PMRGCAuk volunteer]

Hello Buenavista

Methotrexate is commonly used for rheumatoid arthritis and sometimes as a steroid-sparing drug for PMR when people aren't experiencing a good response from steroids alone, especially when on the higher doses. It is taken once a week and generally takes 3-12 weeks before any benefits are seen. It involves regular blood tests to check for any side effects on the liver. Although I haven't taken it, I have known several people to take it alongside the steroids for PMR for differing periods of time. As with all drugs, it appears to help and suit some but not others.

Reading the statement by your English rheumy, it sounds as though he may be uncertain as to whether you have either PMR or Rheumatoid Arthritis, or even both. Perhaps your Spanish rheumy will have some advice to offer on Monday when he has the results of the X-ray.

Arthritis Research UK produce a helpful leaflet on Methotrexate, available free by ringing 0300 790 0400.

Hope Spain is living up to its name and is sunny!

[Hidden]

Buenavista

I take it you live in Spain and the research clinic in Madrid does excellent research on both PMR & GCA.

Expatriates who have PMR and GCA find the treatment and advice they get from the Spanish Medical Profession excellent.

Methotextrate is the 'gold standard' treatment for RA. It is a steroid sparing agent for PMR.

Neither of course is a 'cure' for either.

I would have thought that RA would have been excluded before you were diagnosed with PMR. However you can have both together or go onto to develop LORA (Late Onset RA).

Hope this helps.

[Buenavista]

Hi all, thanks for your replies.

I have looked on a site about Methotrexate. I don't want to go on this unless the rheumy tells me tomorrow that I have to because I have rheumatoid arthritis.

Secondly, I definitely have PMR and will find out tomorrow if I also have RA.

To smoky's question, we have lived for 9 years in the mountains in the south. This is like a third world country and Madrid is to far away. The hospital I am going to is a half hour drive. Unfortunately the rheumy I see doesn't understand the disease. When I saw him on my last visit, he wanted me to reduce down from 8mg of pred, straight to 5mg for 2 weeks, then zero for 2 weeks and so on. I get a lot more help from you guys.

Will let you know how I get on.

Best regards

Buenavista

[Polywotsit PMRGCAuk team member]

Hi Buenavista

If your doctor in Spain has good English, which is likely, it might be an idea to go to our website resources section, and download and print the British Society of Rheumatologists guidelines for the management of PMR. Hope you don't have RA!

[iforget]

I was diagnosed with PsA back in the late 90's and I was on injectable methotrexate for many years. It is a base level DMARD for inflammatory arthropathies (PsA, RA etc) and is often used in combination with other meds, including biologics...for some reason adding MTX back in with a biologic when the biologic's benefits appear to be waning has a positive effect. Sometimes it seems the oldies are still goodies.

The listed side effects of MTX rather dramatically include death...which can be a bit off putting...but this is usually related to user error... for example overdosage by taking the drug daily instead of weekly... as long as it is taken properly and regular blood tests are undertaken for monitoring purposes, it is a very effective drug.

Common side effects include nausea, some fatigue and a bit of brain fog...but all of these are fleeting and usually occur/last 12-36 hours after the dose is taken. It does have an immunosuppressant action and live vaccines should be avoided and if you have an active infection you may need to skip a dose until, you have recovered.

If your PMR is controlled then the only reason for adding in MTX would seem to be if they do confirm a diagnosis of RA.

I hope you get answers soon and that the news is goodl.