PMR and Methotrexate

I started MXT about two months ago. I’ve been on prednisone since December. Started at 40mg of prednisone. The methotrexate level is now 25mg, the highest level. I am now down to 12.5mg of prednisone. Dropping to 10mg next week and then I’m starting the long taper. MXT has really helped me pull down the pred level. Like others have noted some of the side effects of MXT, especially when I first started taking it, were pretty bad. Nausea, bad, headache, fatigue, dizziness. So I just set aside two days a week as much as I could to just deal with the side effects. Now after a couple of months on MXT the side effects or not nearly as bad. One day of light nausea and light headache. I can deal with that. If it helps me get down off of prednisone. My goal is by the end of the year. I’m off pred completely. And then I’ll work on getting off of the methotrexate.

Thanks for that I will persevere & put up with the side effects

Have increased methotrexate to 15mg( from 10mg) & increased prednisone from 5mg to 10mg.
It’s been a week now & no improvement so disappointed but don’t want to increase more.
It’s taken 2 years to get to 5mg.I feel like I’m back to square one.Wondering if the diagnosis of PMR is correct ?

@glyn, I guess I would feel the same way since there are a lot of conditions that mimic PMR. It would certainly be a valid question to discuss with your rheumatologist.

--- Diseases that mimic polymyalgia rheumatica (PMR): https://www.medicalnewstoday.com/articles/diseases-that-mimic-polymyalgia-rheumatica

Hi,

Can just share my experience as over time I had quite serious prednisone side effects. Not good but accelerated discussion about alternatives. Kevzara has been a game changer for me. I was completely debilitated at times and now I can participate more consistently in my life😊. While continuing to hopefully taper off prednisone. My reaction was severe so not sure this is helpful but there are alternative treatments if needed. Thanks and I hope you get some relief.

Many thanks will ask my rheumatologist about Kevzara not sure if we use it in uk.
Don’t understand why after 4 years I am feeling as bad as in the beginning.

I started on methotrexate a month ago with the plan of tapering down from 40 mg prednisone. I did not have any uncomfortable side effects from the MTX but last week my platelets were down to 60 so tge MTX has been discontinued and prednisone raised to 60 mg for a week. We will retest next week.

I def notice insomnia worsening with methotrexate. Have you figured out how to navigate this? I was taking it for PsA and psoriasis.

Just diagnosed withbPMR I am trying to remain off prednisone as it elevates my blood sugar my doctor has suggested that i take a diabetic drug to counteract this. Now I know my diagnosis I’ve decided to stay off medications I’m currently on tramadol and gabapentin whic make the pain tolerable but I would like to taper off those as well I’m going the natural route with nutrition exercise and accupuncture if I can be the way I am for now I would be happy I’m 79 and functional just needed a diagnosis

I am so afraid of all these drugs and the side effects they cause. I was diagnosed with PMR in July 2023, put on Pred 20 mg., the side effects are horrible. Extreme soaking sweating 2 hrs after taking, worsens with activity, weight gain, skin breakdowns/sloughing with bleeding, now I have developed prednisone induced diabetes, on diabetic med and checking blood sugars a couple times a day, not happy! I have many other problems also, now with massive fluid in the shoulders with synovitis and non traumatic rotator cuff tears and now PVNS (pigmented villonodular synovitis) in the other shoulder, all since starting Pred. in July. What is this? Is this RA? Now my Rheumy is concerned and wants me off Prednisone asap--- me too! She started me on MTX (methotrexate) yesterday. I am now down to 7.5 mg of Prednisone. I was down to 8mg in early Nov. but had to go back up to 20 mg of Pred. after my first flare, following a bout with Covid that lasted 2 weeks. I am so afraid to take MTX after reading all this and doing my own research. I am beginning to wonder what would happen if I did not take any meds at all, just live with the PMR pain like I did for 6 months before I got treatment. Has anyone done this? Can MTX really take away the pain and reduce the inflammation of PMR? I am praying for no side effects ....