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Rheumy recommends methotrexate.

Posted , 10 users are following.

Guest
Guest

I worked hard and for almost a year to go from 60 mgs down to 6 when I received an urgent message from my dr. Both my sed rate and my CRP blood work had gone up dramatically in just over one month on 6 mgs. He told me to increase my pred dose to 7.5 and then come in for further testing. He also mentioned methotrexate for the first time. Can anyone give me a heads up on this drug? What I have read online doesn't sound any better than prednisone! Thanks ahead for help, Ann11195

0 likes, 14 replies

14 Replies

  • MrsO-UK_Surrey
    MrsO-UK_Surrey Guest

    Posted

    Ann, to have reduced from 60mg to as low as 6mg in less than a year is no mean feat.  However, it probably means that you have reduced by too much and too soon overall which is very much proven by your present flare, if, in fact, it is a flare.  Yes, if you are someone who had raised markers of inflammation at diagnosis, an increase in your ESR and CRP could point to a flare but those markers can also increase due to the inflammation caused by a lurking simple virus or infection.   Whether this truly is a flare, and flares are quite common in the first 12-18 months, can very much be confirmed by worsening symptoms, but you haven't mentioned how you are actually feeling.  If you have been experiencing increasing fatigue or pain then that could certainly point to a flare.  If your symptoms improve following the increase to 7.5, you will have an answer, although a slightly higher increase may have proved even more successful - many experts recommend an increase of 5mg to get increasing inflammation under control.  As for Methotrexate, I am surprised that your Dr should recommend adding this drug when you have obviously done very well to get as low as you have after such a short time.  It is more understandable for drugs such as MTX to be suggested if/when a patient is repeatedly unable to reduce from the higher doses without a return of symptoms. At 7.5 you are heading towards what is considered among the lower doses.  Personally, I would prefer to stick with Prednisolone at a dose that controls the inflammation than add in another.  Hope that helps.  
  • Judyg
    Judyg Guest

    Posted

    I'm in a similar position to you, with the pros wanting to put me on methotrexate, and I am not keen, however I've only been taking steroid for 4.5  months, and I dont think ever had enough to put GCA into remission!

    I was however told from beginning this would be a minimum of 2 year., and possibly more treatment plan, with these rises and falls in steroids!

    i doubt this has been of much help but hope it reassures you are not struggling with decisions alone!

    i see my rheumy on Thurs, and know he's going to push me towards methotrexate, and I doubt at thus stage I'm going to agree!

    will keep you posted.

     

  • Guest
    Guest

    Posted

    Many many thanks for terrific quick responses. I have no pain but fatigue has been a factor from the beginning of pred. This is my first bad blood work...am just nervous and a little scared because all had been going so well. Again, thanks and I'll send an update soon, Ann11195
  • mphooey
    mphooey Guest

    Posted

    I take methotrexate now and the only bad thing is it severely curtails my alcohol consumption exclaim I am on 5 mg. pred as well and have searing pain in one knee. No tiredness, just some pain in my shoulders probably from lifting myself up the stairs, out of bed, etc. I am going to make appt. with orthopod. This is not PMR or RA. This is OA in one knee.

    Good luck to you.

  • Susanne_M_UK
    Susanne_M_UK Guest

    Posted

    I have just started on methotrexate and took my second 15mg dose yesterday. The first time I took it, I woke the next day with some nausea and was completely wiped out (much more than usual, I'm always wiped out to a certain degree!) for several days. This weekend, I'm ok, no particular side effects.

    The reason I'm finally on MTX is because I am unable to get below 20mg pred without flaring. I've been on very high doses for over a year now, three times having to go back up to 40mg, and the preds are really having a bad effect on me now.

    I've resisted MTX for a while, but have finally given in as I am desperate to lower my preds.

    I have had GCA for about 14-15 months now and before that, PMR for about 5 years when I managed to get down to 2mg pres before the GCA hit me.

    It's a very personal choice to start MTX, there are some alarming possible side effects and you are on a relatively low dose of pres.

  • Guest
    Guest

    Posted

    Thanks Suzanne and mphooey.... Sharing experiences really gets us through this mess...side effects on pred or mxt are awful! Again, thanks. Ann11195
    • Susanne_M_UK
      Susanne_M_UK Guest

      Posted

      Yes, this site helps get us through.

      Let us know how you get on.

  • Grandpa_Pete
    Grandpa_Pete Guest

    Posted

    I have been on methotrexate for about a year. No side effects and I am almost fully recovered. 
  • FlipDover_Aust
    FlipDover_Aust Guest

    Posted

    I have a similar story to https://patient.info/forums/profiles/susanne-m-uk-540373
    • FlipDover_Aust
      FlipDover_Aust

      Posted

      Bollocks! That didn't work!

      I have a similar story to Susanne M. I haven't been able to get my dose lower than 15mg at any point and wax back up to 29mg when the rheumatologist suggested I go on methotrexate. It's a 'steroid sparer' meaning you need less pred as it works better.

      In four weeks I've managed to go from 20mg daily to 10mg. Pretty impressive.

      I've had few side effects from either the pred withdrawal or the methotrexate, although I attest that I also feel wiped out for a day or two after taking the weekly dose.

      I'm back to the Dr tomorrow so I'll see what the next stores are from here

    • Susanne_M_UK
      Susanne_M_UK FlipDover_Aust

      Posted

      Flip, that's real encouragement for me! So often, we read about the negatives of MTX only. I'm having my first fortnightly blood test in a week, so hope all is well with that.

      I had dreaded starting MTX, but your post has really encouraged me. :-)

    • FlipDover_Aust
      FlipDover_Aust Susanne_M_UK

      Posted

      I didn't want to start it either - very negative views on here for the most part, which is where I get most of my information from. 
  • Guest
    Guest

    Posted

    Such encouraging news about mxt! Am much more willing to try it...so far my rheumy had been correct about everything. Have a great day, Ann11195
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