PMR
Posted , 7 users are following.
I have had to stop steroids due to side effects.Today after seeing the rheumatology nurse for counselling am to start methotrexate 15mg once a week.Is anyone else on this regime?
0 likes, 15 replies
Posted , 7 users are following.
I have had to stop steroids due to side effects.Today after seeing the rheumatology nurse for counselling am to start methotrexate 15mg once a week.Is anyone else on this regime?
0 likes, 15 replies
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tina-uk_cwall gillian_25383
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gillian_25383 tina-uk_cwall
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EileenH gillian_25383
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gillian_25383 EileenH
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EileenH gillian_25383
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gillian_25383 EileenH
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EileenH gillian_25383
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Methotrexate is a drug commonly used in inflammatory arthritides but rarely used on its own for PMR since it hasn't appeared to be effective in PMR, pred is reliably so and therefore usually used. Given the fear many doctors appear to have of pred, if there were good evidence that mtx worked in PMR I would have expected it to be used rather more.
I had severe side effects with one form of corticosteroid, methyl prednisolone, which was used at first in Italy for me but as good as none with prednisolone (normally used in the UK) and prednisone (normally used in the US). I was switched to a form of prednisone and all the problems I had with methyl prednisone have resolved: weight gain, skin and hair problems, Cushings syndrome, muscle wasting and a lovely beard amongst others.
There are trials using toxcilizumab in both PMR and GCA which are looking promising - maybe that is something to discuss with your rheumatologist? If you were to go on to develop GCA, which about 1 in 6 patients with PMR do, then methotrexate would not be enough to avoid the risk of loss of vision and a rethink about pred would be needed.
Many of us have suffered pretty horrid side effects but have decided that they are preferable to the pain and disability we suffered with PMR. And in the case of GCA, this is even more applicable. However, I do hope the mtx achieves some improvement in your symptoms.
MrsO-UK_Surrey gillian_25383
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gillian_25383 MrsO-UK_Surrey
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MrsO-UK_Surrey gillian_25383
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gillian_25383 MrsO-UK_Surrey
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EileenH gillian_25383
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Methotrexate isn't "used for both conditions" as a substitute for pred - I hope the rheumatologist hasn't given you that impression. It is often tried as what is called a "steroid sparer" - taking a dose of mtx allows the patient to manage on a lower dose of pred because the mtx potentiates the effect of the pred. Of all the many patients I have met on the 3 forums only a couple have been able to stop taking pred while taking mtx and it isn't clear whether that was actually because they didn't have PMR but late onset rheumatoid arthritis - which doesn't respond to pred in the same dramatic way PMR usually does and you describe.
However - I do hope mtx works for you.
gillian_25383 EileenH
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janet08828 gillian_25383
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I am injecting 20mg methotrexate once a week.
I am taking it combined with prednisolone trying to get the pred dose down. The first 6 months or so I was just on prednisolone, then I was taking oral mtx for a couple of years plus prednisolone and now for the past 3 months or so am injecting mtx and still with prednisolone.
I am not sure what the future plan is except that I am in the process of tapering very slowly at the moment.
I have not experienced any major side effects with mtx - I do have side effects - breathlessness, racing pulse moments, and all the usual culprits - but it is hard to say whether it is the pred or the mtx or just the GCA itself.
Be interested to know how you get on with just methotrexate - good luck
gillian_25383 janet08828
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