Posted , 8 users are following.
Am i the only one, that the doctor never told me mtx would help me to reduce pred.
I was told that i to take it to help my RA.
if i take pred and mtx how do i know which is helping what?
0 likes, 5 replies
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EileenH margaret22251
Posted
mtx is the standard first line approach for RA and if you have it, that is why you were put on it. If it helped reduce the pred that would be a sort of side line. And there are rheumies who realise it is a stab in the dark with PMR and pred.
As to whether it is helping - the rheumy will assess that for the RA. They give it 6 months to see if it improves the signs and symptoms. If there is no deterioration in whatever they used to assess you had it in the first place they'd carry on I imagine. Did you have symptoms that made him think it was RA? Are they any better?
margaret22251 EileenH
Posted
I had problems walking, my hands were swollen to the point i had to have my wedding ring cut off twice, and after scans and xrays they found i have RA in my spine.
I have been on mtx over 12 months now, and my symptoms have improved.
Iget swollen neck, shoulders, arms ache, amd pain down my right side from my ear to shoulder.
So i hope he knows whats what.
I am concerened regarding the nodules on my lungs, but have been told my a specialist its nothing to do with mtx.
They only problems i seem to have with mtx is the bruising, and the cramps i think are to do with PMR, my the way i have got some epsom salts to try foot bath.
He did tell me i have both PMR/RA it seems i am in his hands regarding what i have.
jeannecatlover margaret22251
Posted
I started on pred almost a year ago (10 mg). Got down to 3 mg at one point, then had to go back up to 9, now at 8 mg (I've been stuck at 8 for a while). My rheumy told me the other day that if I can't reduce to 5 or less in the next 6 months, she wants to put me on mtx, because it will help me reduce the pred. At one point she thought I had RA, but now she doesn't, so the mtx would be solely for the purpose of treating PMR and helping me reduce pred.
I can't answer your question, Margaret, but I'm in a similar situation and would love to learn more about the relationship between these meds and whether it would be a good idea to add mtx. I hate the idea of adding another medication and whatever side effects that might bring. But then I also would like to get off pred or at least be able to reduce further without all the pain coming back.
EileenH jeannecatlover
Posted
You have NEVER been at a high dose, and for most people being on 8mg after less than a year would be taken as excellent - the median time to a dose of 5mg is 18 months and that is for people who were started on what I would regard as a "proper" dose. 8mg is what is called a physiological dose, about the same amount of corticosteroid your body makes every day in the form of cortisol. The governing factor now is the activity of the underlying disease and your adrenal function. Most doctors will happily accept 8mg as a long term dose.
mtx is not guaranteed to get you to a lower dose - and it comes with its own side effects. If it were guaranteed to work in PMR that would be one thing. But it is not and immunologists are concerned about the additional use of immunosuppressive medications alongside pred as there is some evidence doing so predisposes to the development of cancers so I would be quite reticent about taking both. I did try it for a month before deciding the side effects really were unacceptable. It was after that month I discussed it at length with an immunologist - and that was it as far as I was concerned.
But one thing I can say with certainty: mtx is unlikely to speed up you getting off pred. It might allow a slightly lower dose. I have a PMRGCA charity friend who used mtx for some time - it did get her to a slightly lower dose but she never felt really well. Then she tried leflunomide which DID allow her to get off pred but it caused neuropathy problems so she had to stop. The PMR was back so she is now trying a half dose to see if that is enough together with pred. It's a personal decision but for me, even after 9 years on pred, I feel well enough on the right dose of pred to say I couldn't accept the risks of leflunomide.
PMR has a median duration of 5.9 years - to be pushing a patient on a low dose of pred after less than a year to add mtx is unfair. Especially when they started at such a low dose.
jeannecatlover EileenH
Posted
Thank you so much for that reply, Eileen. You are such a wonderful help in this forum. I really appreciate all the time you take to help us by sharing your knowledge.