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PMR and Methotrexate

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Kassiebeetle
Kassiebeetle

Have had 3 doses of methotrexate 5 mgms per week with no difference noted in symptoms. Interested to hear if others on Mtx have noticed any difference in the PMR and what those differences are and were you able to reduce the pred any quicker. I did not want to go on the methotrexate but agreed to trial it for a month of 2. I have not noticed any changes. Thanks

Kathy

0 likes, 28 replies

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  • bjmoen
    bjmoen Kassiebeetle

    Posted

    I was diagnosed with PMR in July 2016.  My rheumatologist started me out with 20 mg Pred for 2 weeks then down to 10 and continued to go down until October 2016 I got down to 4 1/2 mg and symptoms came back.  He put me back to 8 mg and I eventually  got down to 5 mg in May 2017.  At that time he added 15 mg MTX and folic acid.  In Sept. 2017 I noticed slight symptoms coming back plus shortness of breath.  I am assuming the MTX is doing no good and is also causing shortness of breath.  Comments please.
    • EileenH
      EileenH bjmoen

      Posted

      You would be better starting a new thread - unless people are following this thread they won't see it.

      I don't understand why he has added mtx at this stage? PMR lasts 2 years and more (usually more). Whatever you do, you won't get the patient off pred much sooner so it is ridiculous to put a patient on 5mg after 9 months onto mtx. In fact - someone has mentioned on a forum recently that their rheumy took them OFF mtx at 5mg because there it doesn't help. Most doctors are happy once their patients are at 8mg or less - that is a physiological dose and at that point you need the pred until your adrenal function returns.

      mtx can cause breathlessness - and I doubt it is helping much. You won't know unless you stop taking it and sometimes people are surprised - but what dose of pred are you on now?

    • EileenH
      EileenH bjmoen

      Posted

      Then if I were you I would say thanks but no thanks with regard to mtx. It is unlikely to benefit you at all and carried its own risks of side effects. At 5mg after a mere 9 months - why rock the boat?

      However - i you have symptoms it could well be because you are on slightly too low a dose. You are never reducing relentlessly to zero, you are looking for the lowest dose that manages the symptoms to stick at until the autoimmune cause of the PMR symptoms has burned out and gone into remission which, as I say, is unlikely to be less than 2 years and more likely to be longer.

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