@tapamil65

That is the great thing that is currently changing about how PMR and GCA are treated. The days when Prednisone was considered to be the "only option" are over.

I took methotrexate (MTX) a long time ago. I was on MTX for more than a year. I was glad I took MTX even though it was eventually stopped because of GI symptoms and elevated liver enzymes. I thought it was worth it to see if MTX would work or not. MTX wasn't a complete failure. MTX helped me decrease my prednisone dose but it didn't allow me to get off Prednisone.

That's a big problem with trying something different. The patient expects some kind of guarantee the treatment works but the doctor can't provide any guarantee. You basically have to try it to see if you like how MTX works for you. Some people like how it works and some people don't. My experience with MTX was mixed. I liked some of the things about MTX but other things were not so good.

I was very happy that I tried MTX when my rheumatologist wanted approval to use Actemra. He specifically wrote that "all options were tried most notably MTX" but I was still unable to taper off prednisone. I got the impression that MTX had to be tried first before Actemra would be approved.

There is now a growing list of medications that can be used to treat PMR/GCA . Having other options besides Prednisone is a good thing!