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GCA prednisone vs. actemra infusion therapy
Polymyalgia Rheumatica (PMR) | Last Active: Mar 7 9:52pm | Replies (24)Comment receiving replies
DadCue….Thanks for sharing your experience. I see now that I forgot to specify that I have GCA (and PMR). I agree that taking 3 immunosuppressants does not sound like a good thing, but inflammation from GCA is definitely not. And the plan is to continue tapering prednisone, hopefully discontinue it or at least get to a low dose.
Replies to "DadCue….Thanks for sharing your experience. I see now that I forgot to specify that I have..."
I too forgot to mention that i have gca and pmr as well. Please let me know how it goes for you on methotrexate. I am Leary of taking so many drugs as well. How can ones bidy handle all if this. I'm still trying to decide on what to do. I wish you luck
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As far as I know, the evidence available for choosing the most appropriate steroid-sparing agent in GCA is between Tocilizumab (TCZ) and methotrexate (MTX).
TCZ is probably first and the next best agent for steroid-sparing effect might be MTX.
I don't think there are any studies that support using both TCZ and MTX together as steroid-sparing agents when someone is still needing high doses of prednisone. I could be wrong ...maybe there is some updated information out there somewhere.
At the very least, I would ask your doctor about the safety of using all three of these medications: prednisone + tocilizumab + methotrexate together. If you are able to get off prednisone quickly on this regimen that would be good. TCZ + MTX is okay if you are off prednisone.
"Treatment failure with tocilizumab has been defined as the inability to achieve remission by week 12 or relapse between weeks 12 and 52."
https://openrheumatologyjournal.com/VOLUME/13/PAGE/61/FULLTEXT/