Using methotrexate with PMR

Posted by smoshetti @smoshetti, 2 days ago

My husband, 72yo, was diagnosed with PMR in March of 2024. He had rather severe symptoms...couldn't get out of chair and pain in neck and shoulders and fatigue. He was prescribed prednisone and tapered to 1 mg over 3 months. At this point was pretty much symptom free. He has hypertrophic cardiomyopathy and saw his cardiologist who told him to stop any prednisone immediately and see a rheumatologist for alternate medication. Blood work for inflammation is elevated but not extreme. He is experiencing symptoms but not as limiting. Rheumatologist is prescribing him methotrexate 10 mg going to 15mg in 2 weeks. He's afraid to take this medication because of side effects yet wants to avoid getting GCA. Anyone have experience with methotrexate therapy for PMR?
Thank you!

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smoshetti | @smoshetti | 1 day ago

In reply to @notacopy "Oh, and also, my rheumy wants me to be on the Methotrexate another year, slowly reducing..." + (show)

Thank you! His rheumatologist hasn't discussed an end date. I suppose he'll have to take it day to day.

prestol | @prestol | 1 day ago

I have been taking methotrexate for five months, because my rheumatologist suspected I might be developing an inflammatory arthritis in addition to PMR. I have had no side effects and it is working very well. I take 25 mg (10 pills) once a week with 1 mg folic acid daily. I have been able to titrate down on the prednisone with only one minor flare, and am now at 6 mg down from 15.

smoshetti | @smoshetti | 1 day ago

In reply to @prestol "I have been taking methotrexate for five months, because my rheumatologist suspected I might be developing..." + (show)

Thank you for sharing this information. My husband is not taking prednisone any longer and will be taking methotrexate and folic acid solely. We're so happy to hear you had no side effects. Thank you once again !!

grumpa | @grumpa | 23 hours ago

Hello, I was diagnose with PMR in 2011, I was also on methotrexate for a few years, with no side effects. It did not help to reduce prednisone . Some though have some side effects. I recently started on Kevzara because I had to increase my prednisone. It’s just been a month so not sure what to expect.

smoshetti | @smoshetti | 22 hours ago

In reply to @grumpa "Hello, I was diagnose with PMR in 2011, I was also on methotrexate for a few..." + (show)

Thank you so much for sharing! Good to hear you had no side effects from the methotrexate.
Best of luck on the Kevzara.

marilyncmesser | @marilyncmesser | 22 hours ago

In reply to @smoshetti "Thank you so much. So glad the methotrexate is working so well. This helps immensely!" + (show)

I just heard of methotrexate. I am glad to hear it works well. But I see you took prednisone first. I wonder if you could have started with methotrexate?

notacopy | @notacopy | 4 hours ago

My rheumy told me that Prednisone works immediately (and it did!) and Methotrexate takes several weeks to kick in.

smoshetti | @smoshetti | 9 minutes ago

In reply to @marilyncmesser "I just heard of methotrexate. I am glad to hear it works well. But I see..." + (show)

Probably could have. The internist thought the prednisone would be alright to take when having hypertrophic cardiomyopathy. The cardiologist is the one who said absolutely not. This is the reason for starting on methotrexate

smoshetti | @smoshetti | 7 minutes ago

In reply to @notacopy "My rheumy told me that Prednisone works immediately (and it did!) and Methotrexate takes several weeks..." + (show)

Yes, that was true! Prednisone gave relief within a day. The rheumatologist told us it might take 3 weeks to feel the effects but at this point he, unfortunately, has no choice.