Question
My wife is on methotrexate 15 mg per week, we have tapered it doen to 15mg every two weeks. in addition she also takes 10 mg of prednisone per day. she seems not to respond to methotrexate but seems to do better when only 10 mgs daily is administered. is ten mg prednisone excessive?
Answer
We generally prefer patients NOT to be on prednisone as it takes it toll long-term on bone quality, risk of diabetes, risk of hypertension, weight gain, etc. The methotrexate dose of 15 mg per week may not be enough. Instead of decreasing the dose of MTX when there isn’t a good response, consideration should be given to increasing ithe dose and/or adding a second disease modifying drug.
