I took methotrexate to try to reduce my prednisone dose. It worked for that as I was able to reduce from 8 to 5mg after being stuck at 8 or higher for 2 years. The side effects were bad for about a month: nausea, headaches and just not feeling well. The methotrexate worked for 5 months, then I got a disease flare-up. The methotrexate also caused my liver enzymes to be high, which means damage to the liver is happening. I'm now taking Kevzara and prednisone. From my experience and everything I have read methotrexate does not work as a sole treatment for PMR. The pain and symptoms of PMR I had could not be endured without treatment. I could barely function, was spiking a fever on an almost daily basis and developed the temporal headaches that can be a symptom of giant cell arteritis, a more serious disease. My impression is that some people have a less severe case of PMR and other approaches may work.