@reets70 @martiesowers @kmb181 @ellegeee and others with experience using methylprednisolone may have some thoughts or experience they can share with you.

Here's more detailed information on long term use if that helps.
"Long-term methylprednisolone administration has been associated with the suppression of the hypothalamic-pituitary-adrenal (HPA) axis (a complex interactive signaling and feedback system involving the hypothalamus, the pituitary gland, and the adrenal glands). Suppression of this axis can result in corticosteroid insufficiency - where natural corticosteroid levels are no longer adequate to maintain vital bodily processes - after the withdrawal of treatment. For this reason, moderate-to-long-term methylprednisolone therapy should be withdrawn gradually."
--- Methylprednisolone: 7 things you should know: https://www.drugs.com/tips/methylprednisolone-patient-tips.

I would still discuss long term use with your doctor or a possibly a pharmacist.

Methylprednisolone is stronger than prednisone:

Prednisone is four times as potent as cortisol, a steroid hormone that is present in the body. Methylprednisolone is five times as potent as cortisol.

I took prednisone for PMR. It decreased my immunity to infections but not to the extent that I had no immunity.

Both methylprednisolone and prednisone belong to the class of medicines called corticosteroids. They are synthetic versions of the hormone cortisol. One of the functions of cortisol in the body is to "regulate the immune response" in order to decrease inflammation.

Since corticosteroids are more powerful than cortisol ---yes, they do lower our immune response to infections. Our immune system is suppressed more but not completely eliminated. We are more susceptible to having an infection that may last longer. Nevertheless, we are not left without any defense against an infection.

The medication we take is a trade-off to controlling excessive amounts of inflammation. Some people say we have an "over-reactive immune system" that needs to be suppressed.

Hello~
I have PMR, Osteoarthritis, DDD, and a few other ailments.
I was diagnosed with PMR about 9 years ago, with much reluctance by my first Rheumatologist, because I was in my 40’s.
But, my symptoms fit to a tee, and my inflammatory markers were through the roof.
Over the first 8 years, I was on Methylprednisolone most of the time. I weaned off a few times, and felt okay for a few months, then the pain came back, and my markers went up. So, back on I went.
2 years ago, I started seeing a Rheumatologist at Duke, (my 4th Rheumatologist), and she said, you cannot stay on Medrol. It is breaking down your body.
Both my Rheumatologist, and my PCP explained to me, that I was very compromised, and would not have a good immune system to fight off infections.
So, last year, my Rheumatologist started weaning me on to injectable methotrexate, and off the Medrol.
I felt absolutely terrible weaning off the Medrol that time. I was physically sick. But, I stuck to it. It took about 5 months. Faster than she wanted, but I knew I had to get off of it.
I took the Methotrexate injections for about 6 months. The side effects were not too bad, and I weaned off much easier.
I have been off all Biologics for about 5 months, though not pain free by any means.
Unfortunately, I got Covid, in December, and it brought about a flare up of PMR, and my markers, this month.
So, I will be taking a dose pack of Medrol, to see if we can knock it out fast. Here’s hoping! How I dread it.
Let me also add, that I started having very bad indigestion, and headaches from long term use of Medrol. And, my stomach will never be the same.
I guess I am considered a lifer. It runs heavy in my gene pool.
Get a good Rheumatologist that will listen to you, and treat you, not just the disease. It can be a long journey.
Good luck!
Kathy