Lung problems from methotrexate

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recently had pneumonia and just had follow up appointment with consultant yesterday. Bronchoscope done while in hospital did not show any bacteria consistent with pneumonia,so consultant has advised that I do not go back on methotrexate which I took alongside etanercept, as he believes that the methotrexate has caused the lung problems, could also be caused by a combination of the 2 meds together. Been on etanercept for about 10 years, it has changed my life where my Rheumatoid is concerned.  Always had problems with methotrexate, so do not want to go back on that anyway, but concerned that it has caused lung problems. Anyone else had this ???

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  • Posted

    Pneumonitis is a side effect of mtx which is found in up to about 5% of patients - google it if you want to know more.

    "Overall prognosis would depend on the exact form of disease. In general the prognosis is considered good, with most patients improving despite continuation of therapy. Patients with lung fibrosis at presentation may have worse prognosis"

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  • Posted

    Hi Carole, yes I too was on methotrexate and Etanercept but had to stop methotrexate for lung problems. I'd had a very 'silly' minor sort of cough from about Jan 2016. I also had a severe chest infection / pneumonitis about April last year resulting in 3 rib fractures. When the infection resolved after numerous antibiotics the 'silly' irritating cough persisted although my chest was 'clear' and nothing showed on chest x ray. I persisted and saw a respiratory consultant. Lung function tests showed nothing but CT lung showed some fibrosis. Review at Christmas showed 'significant deterioration'.  Methotrexate was stopped. The 'silly' cough was getting worse but not productive and I was getting a little more breathless. I was told it could be a consequence of the previous infection or the Mtx or likely a combination of both. Bronchoscopy (lovely!) showed there was some residual underlying infection. Since stopping the mtx, about Jan this year My CT scan has slowly improved. My cough has slowly improved. Not back to my 'normal' but definitely improved. I'm currently back on Etanercept, stopped due to the infection, and prednisolone which I am reducing slowly. I certainly feel the difference in my joints every time I drop it a little more but there's no way I personally would take it again. (I appreciate it suits many people) Good luck, Carole. Hope you continue to improve. Carol x 

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    • Posted

      Thank you Carol, I too am on prednisone whilst waiting for results from respiratory consultant. As with you latest X-ray was clear, but have been told I need a scan and some lung function tests. I think it will probably result in the same outcome as you, as although I feel better than I did, I still do not feel 100%  I am reducing the prednisone too, the problem I have with these pills are that I cannot sleep! I have been up since 2.45 this morning!!!  I have repeatedly told my rheum consultant that I was not happy with the methotrexate, made me nauseous for about 3 days, so I am adamant that I will not be going back on those injections. The other problem is that reducing the prednisone, I can feel my joints beginning to get worse. So not looking forward to yet another full blown flare up, while my consultant decides what else to try me on. Once again, thank you for your reply. Take care
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  • Posted

    Hi Carole, I recently dropped from 10mgs to 7.5mgs of prednisolone and I certainly noticed the difference in my joints. It seems to be settling a little now. I saw my Rheumy nurse on Thursday who advised trying to reduce by just 1mg every 4 weeks. I was concerned they might try to stop them altogether which although I know is desirable I feared the pain. She reassured me that we will try to get down as low as we can while controlling the symptoms. That will mean continuing with the bone protectors, Adcal and Alendronic Acid. She's also requested a bone scan.   It does bother me a little that none of this was detectable on x ray or chest examination. Had I not persisted and 'had friends in high places' things could have gone on a lot longer before I was treated. Good luck. It's good to compare notes!

    Carol x

     

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    • Posted

      Morning carol, your last reply mentioned a bone scan, had results of mine 2 weeks ago, now have osteoporosis, which is another reason that I do not want to stay on prednisone pills.  I do not wish to take the medication for the osteo as I also have a small kidney stone. It is not troubling me at the moment, but having been hospitalised twice with kidney stones, it is not something I wish to go through again. Having had a shoulder replacement in January, plus the pneumonia recently and numerous flare ups of fibromyalgia and RA, I can safely safe it has not been a good year !!! But hay ho, good luck with your scans. 
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