1. < Polymyalgia Rheumatica (PMR)
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New Methotrexate Study in PMR

Posted by sandmason @sandmason, Nov 22, 2024

As seen on X, another study showing no benefit in PMR using methotrexate. I watch a lot of the RheumNow videos on YouTube as they discuss new studies. PMR has largely been ignored I guess because it an old lady disease. Kevzara is a new expensive drug that does help, apparently, if you can get it. We can't even see a rheumatologist where I live.

"#Methotrexate is a dud in #PMR for benefit above #glucocorticoids !

#RCT MTX25mg/wk + Pred 15
Mg/d tapered to 0 at 1 yr vs #Prednisone + placebo same taper

NO BENEFIT from #MTX

#1697 #ACR24
@ACRheum

@RheumNow"
https://acrabstracts.org/abstract/results-of-a-one-year-randomized-double-blind-placebo-controlled-trial-with-methotrexate-25mg-per-week-for-recently-diagnosed-polymyalgia-rheumatica/

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carenr | @carenr | Jul 29 11:10am
In reply to @mtr2601 "I asked my GP what he thought about Methotrexate for PMR and he just said "..." + (show)
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I asked my GP what he thought about Methotrexate for PMR and he just said " can't comment on the Rheumatology, I just deal with a lot of the severe infection side effects from taking it" that was enough for me. My Rheumatologist is still pressuring me to take Methotrexate or Leflunomide despite the fact that Plaqunil has been working for me, without the awful side effects. She also completely denied my bad experience of taking the drug, told me it was all in my head !! I suspect this type of medical bullying and gaslighting is not uncommon when Rheumatologists are dealing with 'frail old ladies'. Thank you for posting this, it validates my experience.

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I was diagnosed in April 2024 with PMR and put on 15 mg prednisone. In Nov., 2024, I saw a Rheumatologist who put me on Methotrexate to taper off the prednisone. It didn't seem to work, and i started getting pains in my wrist, which prompted him to diagnose me with onset rheumatoid arthritis. and osteoarthritis. My Rheumatologist then put me on Leflunomide (along with 7 mg prednisone, and my liver enzymes shot up. I am now off Leflunomide and on sulfasalazine and 5 mg prednisone. i get monthly blood tests. My goal is to taper off prednisone.

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mtr2601 | @mtr2601 | Jul 29 2:57pm

I found it hard to get off the last few milligrams of Prednisone. Every time I reduced a half mg I got a ramping up in pain levels, so I went a quarter mg and spaced out the time frame from 1 week to 2 weeks. I was on Hydroxychloroquine to aid this process and it seemed to work for me without any side effects. Have been completely off both drugs 3 months now. Stopped seeing the Rheumatologist because the drugs she keeps pushing are worse than the disease, I don't think they have much to offer PMR patients other than access to diagnostic scans.
Still in pain but it's OA pain now. Have been tempted to reach for the Prednisone a few times but keep reminding myself that it's not worth it, I can manage.

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