Actemra & Methotrexate for GCA treatment

Welcome to Mayo Clinic Connect. I hope you find the information you are looking for.

@csm70 I take it that your wondering about taking the two medicines at the same time? Is that correct? I found these two discussions that may have some helpful information. I’ll also ask @dontknowitall53 and @tsc if they would join the discussion and let you know of their experiences.
https://connect.mayoclinic.org/discussion/temperol-arteritis-or-giant-cell-arteritis
https://connect.mayoclinic.org/discussion/good-news-actemra-working-for-me/
What do you think your doctor would say if you wanted to stay on the prednisone a little longer? There are bad side effects with pred, as I well know.

Thanks for the feedback, Becky.
I believe my doctor would be ok with the idea of staying longer on Prednisone... But I have been on it for over 7 months now and would prefer to taper it off... My hope is that actemra will speed up the process and hopefully avoid relapses . You are correct, my concern is about taking the two meds at the same time

Hi @csm70 and @becsbuddy, I was taking prednisone for a year and a half, then off it a year, and I'm back on it now with my relapse. I was also offered Acterma this time round. I discussed it with a close friend, a physician who is a top notch researcher and has experience with GCA.

He went over the studies and suggested I stick with prednisone for now since it worked for me last time and is relatively safe. I can always take Acterma if the prednisone isn't effective, so that's what I decided to do for now.

@csm70
My husband developed PMR in May 2023 and GCA in February 2024. Since developing GCA he has been put on Actemra. His case was severe so they gave him three days of IV infusions of high-dose steroids (1200 mg) followed by daily doses of 80 mg Prednisone. He's tapered down to 50 mg at the moment with weekly Actemra injections.

I have not heard of Methotrexate so I can't comment on that. Can you ask your doctor if it would be safe to take only Prednisone and Actemra so you'd only have two meds?

I was doing a little research and found this on the Actemra info page about Methotrexate: https://www.actemra.com/ra/considerations/actemra-works-alone.html

I also found this info on drug and supplement interactions with the Methotrexate. I don't know about you, but our doctor doesn't always tell us things like this. https://www.nhs.uk/medicines/methotrexate/taking-methotrexate-with-other-medicines-and-herbal-supplements/#:~:text=Tell%20your%20doctor%20if%20you,other%20antibiotics%20for%20bacterial%20infections

One last thing. You might find this study interesting. It's on PMR but I would think could apply to GCA as well. I haven't finished reading but it appears to be saying that Actemra helps in faster prednisone tapering than with methotrexate and prednisone.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8267957/

Thanks. . Very valuable information, I will read through today ..

@csm70
I'm glad you found it valuable and hope you can taper the prednisone quickly. That's what I'm hoping for my husband. The side-effects stink!

I, too, have PMR and GCA (giant cell arteritis). Be very aware of issues with anxiety as you taper off prednisone .