Prednisone and methetrexate

Because of long term Prednisone above 5mg, I was put on Methotrexate in November. By May I saw no results from Methotrexate and could not go below 7mg Prednisone. May 23th I went of Hydroxychloroquine and was told to continue the Methotrexate. My great concern is all medications with their side effects. Why do I continue on Methotrexate when I saw no results from it.

I have not seen many that have said it works. MTX is a Rheumatoid arthritis medication to treat inflammation. RA has several drugs to help with inflammation. Its usually the first line of defense when tapering on prednisone. But this drug as with all the other inflammation blockers do nothing for adrenal insufficiency. They are being prescribed to you by the Dr to try and prevent you from having a flare. The 5-7mg range of prednisone is your bodies requirement for cortisol and once you try to taper the AI screams for more. In a lot of cases restarting the PMR. Your Dr may be able to try something else but you need your adrenal glands to start functioning or nothing really works. Just go slow and expect a little discomfort. good luck.

I have to try methotrexate before I can get Kevzara or Actemra with insurance.

yes. sort of dumb. But its been around awhile and cheaper.

Although even if taking the newer biologics they do nothing for AI. They are merely trying to keep your AI from restarting the PMR. Depending on your length of time on steroids you may still have a difficult time below the 5mg

I have been on Prednisone almost 1 year. I really want to get off of it. I got down to 5 mg and still have some pain.

5mg was the hard spot for me. I waited until i was comfortable. Not pain free and then tried again. I was only on 6 months. So month 4 I tried 2.5mg and it was painful. I went back to 5mg for a month and then tried again. It was still painful but not as bad. So I stayed at 2.5mg for a month and stopped. I know that doesnt fit the taper rules but I had only been on for 6 months and really wanted off. It took 6 months to get back to somewhat normal. I would take an alleve in the morning and a tylenol PM in the evening.

Kevzara was still expensive thru my insurance as I was required to meet out of pocket totaling $5000/yr and then insurance would cover it for the remainder of the year. Kevzara has a copay assistance program which allows me to receive it for free….I’ve been on it for three months now and am finally off prednisone but still taking methotrexate along with Kevzara. My PMR is doing better as well. If your insurance co-pay is costly, be sure to check out the co-pay assistance program as they can help you out

I had RA beginning as a teenager (now 68) and was at various times on 25 mg ,10, 5, and then at least tens years at 1mg. And it was impossible to reduce from there. The secondary adrenal insufficiency became severe and yet, it took along time to diagnose. I finally received the help of an endocrinologist who had me on hydrocortisone overlapping with the prednisone and tapered off the prednisone after few weeks, then stop the hydrocortisone a short while later. I felt so much better. Still have flares but in the background of this I have also been on enterecept for the past ten years, so things are somewhat under control. It’s not perfect.
Please do your best to get off prednisone. Wishing you well.

I am on Medicare and supplement.