Anyone having luck while taking methotrexate?

My Dr. switch me to MTX injections (1 ml weekly) because it was more effective than oral tablets. No other meds except daily folic acid. RA pain is now well managed.

MTX needs to be gradually increased. It started at 5 mg and eventually reached 25 mg (10 pills) for me. After about three months I saw improvement.
Recently I switched to the injectable form, since my doctor also believes it is more effective. I have both PMR and inflammatory arthritis.

I agree with the other commenters. My doctor put me on the injectable form, and told me to not look for any improvement for a couple of months after reaching full dosage. I've only been at full dosage for 2 weeks. I am noticing small but important improvements, especially in the energy department. To taper more quickly just in this last week. I am also supplementing with naturopath prescribed supplements, and have changed my diet to eliminate all sugar, alcohol; but huge amounts of any anti-inflammatories I can find. So I understand your frustration, but hang in there. Hopefully you will also see some relief

Just a heads up, I was on MTX for several years for a different auto-immune issue. It worked well, but MTX can cause lung inflammation, and I developed pneumonia with a hospital stay to get well. Hopefully it works for you.

I found methotrexate to be very helpful. I wonder if your dose is too low. I was unable to get lower than 40 mg/day prednisone and my CRP was around 60 so my doctor started me on 20 mg methotrexate daily. My CRP came down (< 5) after about 8 weeks and I was able to start tapering prednisone (currently on 30 mg/day). I was initially prescribed folic acid 5 mg per week, the day after I took the methotrexate, to prevent side effects, but I still got side effects (really nasty sores in my mouth) so was switched to leucovorin 3-5 times weekly, and I haven't had any other side effects. The methotrexate does compromise the immune system, making you more susceptible to infections. I developed a severe case of shingles, and was told to stop the methotrexate until it resolved. I have restarted and hope to further reduce my prednisone after my blood test results next month. Another issue is that methtrexate can damage the liver, so my doctor has me on frequent blood tests to monitor this. I really hope you start feeling better soon. Good luck!

I was diagnosed with PMR last June. My prednisone doses have been on a roller coaster due to flares as soon as I get below 10mg. I finally saw a rheumatologist 3.5 weeks ago and she decidec to put me on Methotrexate., 20 mg pills once a week followed by 2 days of folate with the plan to wean me off prednisone. I am to have blood work monthly .
I am currently on 11mg prednisone daily. She explained that it would take 6 to 8 weeks before the Methotrexate makes a difference. I took my 3rd dose Sunday evening. She warned me to stay away from sick people as much as possible. So I am masking when I go out and wash my hands regularly (hello Covid😷).
So far I can't say I have noticed any side effects. I have quite a few from the prednisone. So hard to say really. Warm wishes to you on your recovery. Let us know how you are doing as time progresses. I'll give updates too.

I have been on MTX for three weeks. I am also on hydroxychloroquine . One day a week I take 10 mg of MTX dividing the dose up. I also take the folic acid daily. I notice every doctor has their own plan. I believe in a way it’s kind of like hit or miss because there really is no magic magic plan each of us just hopes we start feeling better!!! With this MTX I get the feeling it works very slowly before you start feeling better. I’m trying to be as patient as I can after trying so many different medication’s. My very best wishes to you!!!

There was a recent research paper posted a while back in the forum that indicated MTX was not very effective in PMR. 5mg is a very low dose maybe your Doctor is hoping you will build up a tolerance before increasing. I was started on 10mg and had a bad reaction to it.
Hydroxychloroquine is also not supposed to be very effective in PMR but I have found it helpful and have been on it for 18mths with no issues as long as i stay on 200mg and dont try to increase. I am now finally off the Prednisone. HCQ comes with much lower infection risks and less liver irritation but it makes me dizzy and nauseous if I go over 200mg. It's all a gamble and you have to weigh up the risk/benefit for you personally.

@mtr2601

"I am now finally off the Prednisone."

"It's all a gamble and you have to weigh up the risk/benefit for you personally."
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I'm glad HCQ works for you and that you are off prednisone. I used to think prednisone was the only option until something else worked better. The bottom line ... whatever works for you personally is a good thing.

I had mixed results from MTX but I wouldn't have known if it worked for me or not had I not tried it to see if it worked. You are right that everything that is tried is a gamble.

Do you feel better being on HCQ and off prednisone?

Hi, yes I do feel better on HCQ. I tried stopping it while I was still on 0.5mg Prednisone and noticed a difference in stiffness and brain fog within a few days. I went off it for a couple of weeks to see if things normalised but went back to the 200mg daily dose and started feeling better within the week. I am unusually sensitive to these ant-inflammatory meds, even the Rheumatologist had to admit this after initially chewing me out for being 'non compliant'. It's such a relief to kick the Prednisone. I don't think I could have done it without a major flare up if it wasn't for strict adherence to the celiac diet over the last 6 months. My CRP is still hovering between 9 and 12 so there is still inflammation and the hip pain is ever present but not limiting me too much. It has been quite a journey.