Can methotrexate be used as a steroid sparing agent in the treatment of polymyalgia rheumatica and giant cell arteritis?

Article Abstract:

Additional treatment with methotrexate (MTX) does not seem to reduce the amount of steroid needed to achieve remission in patients with polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) who are taking the steroid prednisolone. Remission is when the patient no longer has any symptoms of the disease and can discontinue drug treatment. Researchers compared the time to achieve remission in 21 patients with PMR, some of whom also had GCA, who were taking either prednisolone plus MTX (study group) or prednisolone plus placebo (control group). Time to remission was 48 weeks among the patients in the study group and 45 weeks among the patients in the control group. Fifteen patients (71.5%) were not taking any steroids after two years. Symptoms of the disease returned sometime during the study period among 10 of the study group patients and among 9 of the control group patients. There was no relation between results of tissue sample tests and symptoms of GCA in six of these patients.

Health aspects, Methotrexate, Giant cell arteritis, Temporal arteritis

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Changes in bone mass during low dose corticosteroid treatment in patients with polymyalgia rheumatica: a double blind, prospective comparison between prednisolone and deflazacort

Article Abstract:

There appears to be significant bone mass loss in patients with polymyalgia rheumatica treated with either deflazacort or prednisolone. Researchers measured bone mineral content (BMC) in the spine and arms of 30 patients treated with either deflazacort (14) or prednisolone (16) before and 3, 6, and 12 months after beginning treatment. After one year of treatment, there was a 6.4% loss of BMC in the spine and a 1.8% loss of BMC in the arm. At this time point there was no significant difference in BMC between the two steroid treatment groups. There was, however, a greater loss of spinal BMC and more muscle pain reported in the deflazacort group at three months of treatment. Rate of BMC loss was greatest in the first three months of treatment.

Bones, Physiological aspects, Corticosteroids, Adrenocortical hormones, Bone density, Bone resorption, Prednisolone

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Similar abstracts:

• Abstracts: Treatment of polymyalgia rheumatica and giant cell arteritis. I. Steroid regimens in the first two months. Influence of non-steroidal anti-inflammatory drugs and disease activity on serum alkaline phosphatase concentrations in rheumatoid arthritis, osteoarthritis, and polymyalgia rheumatica
• Abstracts: Treatment of polymyalgia rheumatica and giant cell arteritis. I. Steroid regimens in the first two months. part 2

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