long term prednisone vs methotrexate for pmr

Question

I was first diagnosed w/ pmr in 2001..originally on prednisone then added methotrexate to taper off prednisone… I was in remission for about 1 yr only using otc meds… In past year have had flare ups and have been on 3- 4 mos of tapering prednisone dosing on several occasions.. If I had to make a choice of long term low dose prednisone (5 mg or less ) vs methotrexate which one would you consider to be less harmful in the long term?

Answer

This depends on how well you tolerate prednisone and if you have other conditions (diabetes, high blood pressure, osteoporosis, herat disease, obesity) that might be worsened with prednisone. In general, if you are at 5 mg or less of prednsione, it is not worth the risk and hassle of adding methotrexate.

Alan Matsumoto, M.D.

About Alan Matsumoto, M.D.

Part-time Faculty, Division of Rheumatology
Johns Hopkins University