PMR and Methotrexate

I'm finally down to 2mg Prednisone after 1 year. About 8 months ago I had terrible pain in both my hands. Could not even pump gas. Started on Methotrexate, and pain in both hands completely gone! Rheumatologist said my inflammation numbers were off the chart prior to Methotrexate. Goal now is to get off Prednisone completely, then tackle the RA.

Ha!, well, I guess I don't have to worry about these side effects anymore. I have been taken off MTX and am being rapidly weaned from Prednisone (1 mg every 2wks, at 6 now then will dc) Why? because I don't have PMR or RA, I had been mis-diagnosed for more than 6 months! I have Multiple Myeloma (cancer of bone marrow plasma cells causing bone destruction, hence the pain) and Systemic Amyloidosis (depositing protien fibers into all my joints and organs)--- a double whammy! I am now on my 5th chemo treatment (1x/wkly, multiple chemo drugs) I will post more (probably in my initial post about PMR) once I have a clearer picture of the type, stage and prognosis, etc. What is important are the symptoms that can mimic PMR and the fact that prednisone masked the symptoms of Myeloma and Amyloidosis.

What a terrible series of events. Wishing you only good fortune as you make this abrupt shift. ❤️

My Dr. Started me with Prednidone -25mg and 15mg Methotextrate 1x a week and I take 2 mg folic acid daily. First two weeks I was tired, now it is fine.
The logic is that it can take up to 12 weeks for the anti- inflammatory benefit of Methotextrate to kick in. The ideas is to titrate off the prednisone and that the Methotextrate helps to do that. Once off prednisone can try to stop Methotextrate. Methotextrate at this low dose seems pretty safe- been used for 40 years for RA.
They suggest slow taper of prednisone. Once at 10 mg prednisone- go down by 1 mg every 3 weeks. I am at 12.5 mg. Now.
Will see how I do.

Well
I’m sure he will be monitoring your liver enzymes. Make sure he does get AST & ALT levels. I had to stop methotrexate because it was making liver enzymes spike.

Yes, checking liver function is essential! What amount of Methotextrate were you on, for how long, when it made it spike? I have talked to two folks with RA who have been on it for 30 years doing fine. It is all so personal to our own body chemistry- regular blood tests are essential! Thx for the reminder.

I was on 22 mg along with a biologic Humira and then Enbrel… For about 3 years total - both in pill form and then by injection.

I’m wishing you successful treatment and a full recovery. How did you finally get a proper diagnosis?

Thank-you! In addition to my joint symptoms, I had these strange skin lesions, purpura, in, of all places, my groin and my eyelids. I went to a dermatologist, who did skin biopsies, came back Amyloidosis. That sent me on a journey to find an Amyloid specialist, at the Cleveland Clinic, who did a barrage of testing that also found Multiple Myeloma. Both are rare, incurable but treatable, and can mimic PMR and/or RA symptoms. Unfortunately, I had symptoms and un/misdiagnosed for over a year before actual diagnosis, allowing it to worsen. But...I am confident I can, hopefully, achieve a long-term remission. My hope is that other folks and physicians are aware of this as a possibile differential diagnosis.

I do know that it was suggested to me also, but I had some surgeries scheduled and I was told I would have to stop it carefully some time before the surgery and should be cautious how I began using it again ( I don't know what they meant about the last part)