Using methotrexate with PMR

I am an otherwise very healthy and active 83 year old woman, and I've been taking Methotrexate since 11/23 after my initial diagnosis of PMR in 10/23. I am down to 4 pills/day (10 mg). I have had no side effects and have fortunately not had a flare up of the PMR since the original onset 09/23. I was on Predisone for five months, finally tapering down to zero 03/24.
The only problem for Methotrexate according to my rheumatologist is that it can make one 20-30% more likely to catch an infection although I have been quite healthy since this all happened.

Good luck to your husband!

Hello @smoshetti, Welcome to Connect. Sorry your husband has to deal with PMR along with his hypertrophic cardiomyopathy. My PMR is now in remission. I don't have any experience using methotrexate for PMR but I'm sure there are other members who can share their experience. While you wait for other members to respond, you may want to scan through the discussions and comments by members on methotrexate side effects. Here's a link to the discussions and comments - https://connect.mayoclinic.org/search/?search=methotrexate+side+effects.

You might also find the following discussions helpful:
-- Methotrexate / Actemra: https://connect.mayoclinic.org/discussion/methotrexate-actemra/
-- PMR and Methotrexate: https://connect.mayoclinic.org/discussion/pmr-and-methotrexate/
-- Alternative to Prednisone for Treating PMR?: https://connect.mayoclinic.org/discussion/alternative-to-prednisone/

@tsc, @dadcue, @nyxygirl and others may also have some thoughts or information based on their experience with PMR. What side effect of methotrexate worries your husband the most?

I took methotrexate for 5 months or so for PMR. Nausea was bad the first week or two but I persisted because I hadn't been able to drop prednisone below 7 mg. The drug allowed me to drop to 5 mg but then it seemed to stop working and my liver enzymes went high so I got off it. If I were in your husband's situation I would try it. It's important to keep inflammation under control but I'm not sure methotrexate could prevent GCA. That's a good question for his doctor.

Thank you for the information!

Thank you for the additional resources! He is worried about the possibility of nausea and more fatigue.

I was diagnosed with RA and/or PMR in July '24 and went on 20 mg Prednisone and was able to reduce over 4 or 5 months down to none. Some weeks I had to increase use due to pains but did successfully transition over to methotrexate ( 8 x 2.5 mg/week taken all at the same time) and feel pretty much pain and symptom free except some occasional daily pain in my shoulders and hands - lasts no more than a couple of minutes. So either the methotrexate is doing it's job or I'm in remission (doubt that). I haven't gotten any side effects and recent bloodwork showed no problems with liver function, etc..So all is good - right now!

Thank you so much for sharing your experience. You're right in that the chronic inflammation isn't good for him either.

I can understand his concern. Luckily I did not experience any of either of those symptoms.

Oh, and also, my rheumy wants me to be on the Methotrexate another year, slowly reducing the amount I take.

Thank you so much. So glad the methotrexate is working so well. This helps immensely!