Methotrexate for corticosteroid-resistant polymyalgia rheumatica and giant cell arteritis

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Three patients (one with polymyalgia rheumatica with jaw claudication and two with biopsy-proven giant cell arteritis) were initially treated using prednisone (40–60 mg daily). The response was good in all three, but each experienced exacerbation of symptoms and elevation of Westergren sedimentation rates (WSR) with dose reduction. The addition of methotrexate (7.5–12.5 mg/wk) resulted in diminished symptoms and lower WSR and proved to be steroid-sparing.



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