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PMR and Methotrexate

Polymyalgia Rheumatica (PMR) | Last Active: 1 day ago | Replies (200)

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@linda7

This seems like a high initial dose and a very fast taper to me. I have had PMR for 15 mos. My taper was: 20 for 3 weeks, 15 for 4 weeks, 12.5 for 4 weeks, 10 for 4 weeks. Below 10 I have had 3 flare-ups and have not been able to keep to the schedule of 1 mg/month drop. I am at 8 mg and my rheumatologist thinks I have been on prednisone too long at higher doses and wants to add methotrexate. I am resisting because of the side effects of methotrexate and uncertainty about whether it will control symptoms and I'll just be on another toxic drug. I have been self-monitoring for side effects of prednisone, checking my blood pressure, blood sugar and heart rhythm. I had my eyes checked for glaucoma and cataracts. No real problems. I asked for a DEXA scan for my bones and we will do that. If all these checks for side effects don't turn up anything I will push for staying on just prednisone for a little longer. My rheumatologist would be much more comfortable if I could get to 5 mg. I don't know your health history and your doctor may have valid reasons to get you off prednisone faster. I do not have have significant health problems other than PMR. I'm 72 yo.

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Replies to "This seems like a high initial dose and a very fast taper to me. I have..."

Thank you for your input. I started out my prednisone at 15mg - didn't help at all. My doctor jumped it to 40mg. After about 2 months, my blood PMR test (CRP, QUANT and ESR-SEDRATE) reflected normal. Started the decrease by 10mg per month - now I'm stuck at 20mg with my symptoms returning. I'm 62 years old and do not have any major health problems. Everything that I have read, and your comment confirms, it seems like an aggressive taper. I also do not want to be on another toxic drug. Yet if there is a plan that has been successful to get this into remission and retain that state, I'm all ears. This is miserable.