Methotrexate for corticosteroid-resistant polymyalgia rheumatica and giant cell arteritis.

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.