PMR and Methotrexate

I am curious about whether people’s rheumatologists suspect RA in addition to PMR when Methotrexate is used. That is my situation, because I have a lot of stiffness and some hand pain. My rheumatoid factor labs were negative when I was diagnosed with PMR last January, and it would not be helpful to recheck them now, she says. Not sure why.

Has anyone suggested Kevzara since I am sure you have tried many drugs to treat PMR. That is what my rheumatologist is trying after hydrochloroqin and then sulfasalazine. Both of these drugs have side effects. I realize that Kevzara has side effects and would like to hear of others who have taken it. I am also on prednisone and have been on and off that for years.

I have been o suflasalzine for about a year and a half. 2 tablets twice daily on a full stomache. I think it helped me along with the Prednisone.

Hi JF,
I did try Kevzara autoinject. Had immediate chest pain but really was skin reacting with itchy skin eruptions. My hand pain was called palendromic pmr. Tried Kevzara once more and had horrible headaches. Prior to this I had 5 injections of Methotrexate with other side effects. It is not approved for PMR but rheumatologist seem to lump the two diseases together even without positive labs. I must say my hand cramps and aches improved so will see what comes next. I have never been offered any of the other medications I see here.
Good luck to you!
Karo

I am taking Folic Acid too - everyday. I will have to check on whether I should be taking on Metho day.

I am 72. My PMR turned into Rheumatoid Arthritis.

Two months after I went off the PMR, my C Reactive Protein went up again and my rheumatologist sent me to Vancouver to get a special scan of my blood vessels.

The rheumotologist said he thought it was rheumatoid arthritis. All the scan showed was that I had some inflammation.

I started on Methotrexate. It has reduced the swelling around my joints and I can walk better. It also took care of a rash I had which was in the end was psoriasis.

My problem is that with all that has happened, it has affected my emotional well being. I am not motivated to do anything the last months.

I have been in a 12 Step fellowship for 24 years.

I have a Higher Power and I do believe that things happen “for us and not to us.”

I live alone. I am on a fixed income because of my divorce as he lied and stole.

I still do everything for my program every day. It’s just the joy is gone.

I don’t think you have to taper off of methotrexate unless you think it's really helping you. I took it for 3 months and didn’t help me so I was told to just stop.

"I started on Methotrexate. It has reduced the swelling around my joints and I can walk better. It also took care of a rash I had which was in the end was psoriasis."
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This would make me suspect psoriatic arthritis.
https://www.mayoclinic.org/diseases-conditions/psoriatic-arthritis/symptoms-causes/syc-20354076
"The most commonly used disease-modifying antirheumatic drug (DMARD) is methotrexate (Trexall, Otrexup, others)."
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I don't think PMR can turn into Rheumatoid Arthritis or any other type of inflammatory arthritis. Sometimes PMR is misdiagnosed in the beginning. The other likely thing that happens is you may have PMR in addition to inflammmatory arthritis.
https://www.healthline.com/health/polymyalgia-rheumatica-vs-rheumatoid-arthritis#symptoms

Thank you for the suggestion. I had read it before.

I am pretty sure I had PMR for sure. I was off the Prednisone for 4 months when the C reactive Proteins and sedimentation rates went up.

I did not have any issues with my feet or hands with PMR.

I was also assessed for Giant cell. It is a special scan of my blood vessels. There are only a half of dozen or so of these scanners in Canada.

They found only inflammation that would suggest RA.

I have a Rheumotologist here in Victoria and another one in Vancouver.

The methotrexate is working well. Just nausea and tiredness for side affects.

Being on the prednisone turned me into an angry person i.e. changed my personality and I was suicidal.

I also put on a lot of weight in the year and half I was placed on it.

Actually, I am grateful, it is RA as the methotrexate is easier to take. Apparently late onset RA is more difficult to diagnose. I wish you well.

I just remember how hard it was for me to accept that I had more than one autoimmune condition. I was diagnosed with Reactive Arthritis (ReA) at least 20 years before PMR was diagnosed. My very first question that I asked when PMR was diagnosed was, "What happened to ReA?"

I didn't think a person could have more than one autoimmune condition until my rheumatologist informed me that ReA didn't go away. Now I have PMR in addition to ReA. Over the years ReA was mostly forgotten. My rheumatologist said she was treating "systemic inflammation" but PMR was my "primary diagnosis" with a "history of ReA."

My rheumatologist believes that I had a partial response to Methotrexate when it was tried. Partial or not ... everything was still hurting plus my liver didn't like Methotrexate.

After PMR was treated with Actemra it became clear that ReA didn't go away. I had a flare of uveitis which is associated with ReA and not PMR. My rheumatologist said Actemra clearly worked for PMR but it might not work for ReA and uveitis.

I was on Humira which is a TNF-inhibitor used for inflammatory arthritis. Humira didn't seem to work for PMR. Since Actemra got me off Prednisone, I elected to take Actemra instead of Humira. My dose of Actemra has been tweaked numerous times. Now Actemra seems to work for all of my autoimmune problems or "systemic inflammation" as my rheumatologist prefers to call everything.

Both Actemra and Kevzara were originally treatments for RA but I don't have RA ... thank God.

Do Canadians celebrate Thanksgiving in the context of the Pilgrims --- English settlers who established the Plymouth Colony in North America in 1620, arriving on the Mayflower and settling in what is now Massachusetts?

Many countries only celebrate the "harvest season." I'm not sure what Canada does but Happy Thanksgiving!