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← Return to PMR and Methotrexate
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I'm 75 y.o. male with pmr for 3 years with multiple relapses and dose increases. Started mtx 3 months ago at 10mg weekly then increased to 15mg weekly for last 2 months. Was on 7.5 mg of prednisone and got down to 4.5 after the 3 months. Pmr symptoms returned and crp elevated more each month. Rheumatologist said just stop mtx and increase prednisone to 10 mg. This worked but wondering if anyone else found no results from mtx?
Replies to "I'm 75 y.o. male with pmr for 3 years with multiple relapses and dose increases. Started..."
I was lucky with methotrexate. My rheum got me onto it after inflammation returned when I was down to about 2-3 mg prednisone daily, last February. At the moment, I'm off prednisone (tapered completely off almost 3 months ago) but still on 15 mg methotrexate weekly, which I take on Saturdays, 7.5 in am, 7.5 in pm. He said I should expect to stay on it for about another year, though.
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I have seen lots of posts where MTX did not work. Its an RA drug being used to treat inflammation. RA drugs are a lot more plentiful. There are newer biologics that target the IL-6 receptor. They have shown IL-6 to be elevated in PMR patients. Actemra is designed to treat GCA as well. Kevzara is the PMR drug. I have also seen where these drugs including MTX can take 8 to 12 weeks to start working. But keep in mind all these inflammation drugs are designed to keep your CRP down while trying to taper. They do nothing for restarting your cortisol. Below about 5mg of prednisone is going to still require a very slow taper and restarting your adrenal glands.