PMR and Methotrexate

Posted by paulinef @paulinef, Mar 15, 2018

I have been on prednisone for about a year and am finally down to a daily 7 mg dose. However, still feeling some stiffness and my rheumatologist has suggested a couple of times that I could could also go on Methotrexate. I'm reluctant to take yet another medication though so am wondering if anyone else has tried Methotrexate and if it helped lessen the PMR symptoms.

Hello @pualinef, my first round with PMR it took my 3 years to finally get off of prednisone. The PMR came back about a year or so ago and I went back on a 20 mg dosage of prednisone which I started tapering off after a month or so. I have been off of prednisone for about 15 days now but I still have some joint pain and stiffness. I'm learning to live with it unless it gets worse. I have no experience with Methotrexate but did find a study that I think may provide some help to answer your question.

NIH – Methotrexate in polymyalgia rheumatica: preliminary results of an open, randomized study.
https://www.ncbi.nlm.nih.gov/pubmed/8730115

John

Pauline…I have never been on Prednisone and have been on Methotrexate by injection once a week. I have no idea what Methotrexate is to do. Must be fighting off potential infections. Other than that I don't see how it is benefiting me. I still have terrible pain and could sleep around the clock.

@I was on methotrexate for over 8 years. Had to go off it because of very bad anemia of which is a side affect of methatrexate.

@johnbishop

Hello @pualinef, my first round with PMR it took my 3 years to finally get off of prednisone. The PMR came back about a year or so ago and I went back on a 20 mg dosage of prednisone which I started tapering off after a month or so. I have been off of prednisone for about 15 days now but I still have some joint pain and stiffness. I'm learning to live with it unless it gets worse. I have no experience with Methotrexate but did find a study that I think may provide some help to answer your question.

NIH – Methotrexate in polymyalgia rheumatica: preliminary results of an open, randomized study.
https://www.ncbi.nlm.nih.gov/pubmed/8730115

John

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Hi John – thank you very much for the link to the article which is very interesting and quite encouraging. It leads me to think it might be worth trying if I continue to need to stay on prednisone.

@johnbishop

Hello @pualinef, my first round with PMR it took my 3 years to finally get off of prednisone. The PMR came back about a year or so ago and I went back on a 20 mg dosage of prednisone which I started tapering off after a month or so. I have been off of prednisone for about 15 days now but I still have some joint pain and stiffness. I'm learning to live with it unless it gets worse. I have no experience with Methotrexate but did find a study that I think may provide some help to answer your question.

NIH – Methotrexate in polymyalgia rheumatica: preliminary results of an open, randomized study.
https://www.ncbi.nlm.nih.gov/pubmed/8730115

John

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An update on methotrexate: been on it for about a month along with 4 mg prednisone until first I came down with a respiratory bug caught off my husband. It took ages to shake off but I had no reason to think I should come off the metro until I cut my calf quite badly on a sharp object. This evolved into a nasty infection and I had to go on heavy duty antibiotics – I wasn’t warned that Metho hinders healing so continued taking it until I finally thought to call the rheumatologist who said to come off it until the cut had healed and no longer on Cephalexin.. So the warning to people on metho is to be very careful not to catch anything or cut yourself and if so, do not continue to stay on it. Neither the pharmacist or the two Doctors had warned me to come off it when it was prescribed unfortunately. ….

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@johnbishop

Hello @pualinef, my first round with PMR it took my 3 years to finally get off of prednisone. The PMR came back about a year or so ago and I went back on a 20 mg dosage of prednisone which I started tapering off after a month or so. I have been off of prednisone for about 15 days now but I still have some joint pain and stiffness. I'm learning to live with it unless it gets worse. I have no experience with Methotrexate but did find a study that I think may provide some help to answer your question.

NIH – Methotrexate in polymyalgia rheumatica: preliminary results of an open, randomized study.
https://www.ncbi.nlm.nih.gov/pubmed/8730115

John

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I’m sorry nobody advised you on this.  I recently had lung cancer surgery and then I got an abscess on my liver so I have a PICC line for antibiotics.  My Rheumatologist told me to quit taking Simponi and he also won’t let me have any cortisone or prednisone because of the antibiotics.  I believe Methotrexate is in the same family as Simponi, or similar. @marylou705

@johnbishop

Hello @pualinef, my first round with PMR it took my 3 years to finally get off of prednisone. The PMR came back about a year or so ago and I went back on a 20 mg dosage of prednisone which I started tapering off after a month or so. I have been off of prednisone for about 15 days now but I still have some joint pain and stiffness. I'm learning to live with it unless it gets worse. I have no experience with Methotrexate but did find a study that I think may provide some help to answer your question.

NIH – Methotrexate in polymyalgia rheumatica: preliminary results of an open, randomized study.
https://www.ncbi.nlm.nih.gov/pubmed/8730115

John

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I am sorry but have never used methotrexate

Anyone still following? Have been on methotrexate 3-4months. Had relapsed on prednisone dose of 12.5. Now reduced to 7.5. With folic acid, side effects of methotrexate are minimal. Still painful muscles, especially in am, but tolerable. So helpful to hear from others dealing with pmr.

@amom7

Anyone still following? Have been on methotrexate 3-4months. Had relapsed on prednisone dose of 12.5. Now reduced to 7.5. With folic acid, side effects of methotrexate are minimal. Still painful muscles, especially in am, but tolerable. So helpful to hear from others dealing with pmr.

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Hello @amom7, welcome to Mayo Clinic Connect. You are definitely not alone. There are a lot of us still following the discussion. Thankfully my PMR is in remission. I've had 2 occurrences of PMR, both were treated with 20 mg prednisone until I was able to taper off – 3 years for the first occurrence and 1-1/2 years for the second occurrence. I think we all learn to live with a little pain while we try to taper off. Does your doctor or rheumatologist have any suggestions for tapering off? I've never been treated with methotrexate so have no experience with it. What dosage of methotrexate are you taking with the prednisone?

@johnbishop

Hello @amom7, welcome to Mayo Clinic Connect. You are definitely not alone. There are a lot of us still following the discussion. Thankfully my PMR is in remission. I've had 2 occurrences of PMR, both were treated with 20 mg prednisone until I was able to taper off – 3 years for the first occurrence and 1-1/2 years for the second occurrence. I think we all learn to live with a little pain while we try to taper off. Does your doctor or rheumatologist have any suggestions for tapering off? I've never been treated with methotrexate so have no experience with it. What dosage of methotrexate are you taking with the prednisone?

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15 mg once weekly. Am tapering prednisone by 2.5 but the next drop will be after 2 months. Once off prednisone, hopefully can start tapering methotrexate. 😕 just fearful of relapse. Was really bad. Needed a 3 day dose of prednisone at 60 mg ,then30 and down.

@amom7

15 mg once weekly. Am tapering prednisone by 2.5 but the next drop will be after 2 months. Once off prednisone, hopefully can start tapering methotrexate. 😕 just fearful of relapse. Was really bad. Needed a 3 day dose of prednisone at 60 mg ,then30 and down.

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My first occurrence with PMR I went back and forth between 1 mg and 1/2 mg prednisone and for about six months. Going back and forth weekly until I was able to stay at 1/2 mg dosage. Then I had the same problem going from 1/2 mg to being off. It seemed much easier my second time around with PMR which was about 6 years later.

@amom7

Anyone still following? Have been on methotrexate 3-4months. Had relapsed on prednisone dose of 12.5. Now reduced to 7.5. With folic acid, side effects of methotrexate are minimal. Still painful muscles, especially in am, but tolerable. So helpful to hear from others dealing with pmr.

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Hello, hopefully my small contribution might help. I was taking 10 mgs of methotrexate once a week with folic acid for over seven years. I stopped abruptly and there were no side affects. Peach

I was diagnosed last December with PMR. Started on 20mg of prednisone, did wonders for me, now down to 5mg. I am stiff in the morning, but then I start walking, which helps, then later on do a few flexibility exercises while watching the news on T.V. I do not ever expect to be completely pain free, just have it at a manageable level. (It would be wonderful if I were to become pain free0 I emphasis diet and exercise along with my medication. Hope this may help you

Interesting how differently pmr can manifest itself and the amount / kind of meds needed for each individual. For me, stiffness in hands and neck ( RA or osteoarthritis probably ) is much easier than the muscle pain ( PMR ). Anyone have vasculitis at their ankles / shin ? Cleared up with prednisone. Do appreciate everyone’s input.

I have osteoarthritis in my hips and lower back. Prednisone helped lessen the pain, however, now that I am tapering, I take a couple of strong 650mg Tylenol (I cannot take ibuprofen family of drugs) about an hour before I take the dog to the park, or anywhere else that includes a lot of walking

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