← Return to 2 year struggle to get off prednisone still hard to get from 3 to 2mg

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@dadcue

Thank-you for sharing this information. It is always interesting how other countries treat their medical conditions.

In the USA, prednisone tablets actually come in two forms. One is the more common form — a "regular" immediate-release form that can be split or cut in half but it is tedious because the tablets are small. There is also a delayed-release formulation, called Rayos. Prednisone and Rayos are the same medication, but Rayos is designed to start working 4 hours after you take it. Rayos is the coated form of Prednisone that can't be divided.

I doubt anyone in the USA is allowed to have Rayos except possibly for rare circumstances. Insurance companies say it is too expensive and not medically necessary so they won't pay for it.

I'm always curious whether or not there is any medical research that supports a tapering plan like you suggest. There are many tapering strategies but no research that supports one strategy more than another. Whether one strategy works better than another is purely subjective. I think doctors in the USA would support it if there was evidence this tapering strategy works. Do doctors in the UK actually prescribe prednisolone that way?

I tried every tapering plan I could think of after PMR was diagnosed. I failed miserably for more than 12 years. It was hard on my ego not to be able to taper off prednisone quickly. I was able to successfully taper off Prednisone countless times during the 20 years before I was diagnosed with PMR. I was able to taper off Prednisone quickly when treated for a different autoimmune condition called uveitis which can also lead to blindness. A 100 mg to zero Prednisone taper in a month or two was never a problem. Granted that was to treat another autoimmune condition that was more "responsive" to prednisone and went into remission quickly. My ophthalmologist praised me for being "skilled with prednisone tapers."

In my opinion, the "pain symptoms of PMR" respond to prednisone but the "PMR condition" does not. I base this opinion on being able to taper off prednisone very quickly after a biologic was tried. PMR actually responded well to the biologic so I don't take prednisone anymore. My condition has improved dramatically! Once my PMR condition was targeted and treated ... then I was able to taper off Prednisone relatively quickly which is what my rheumatologist wanted to happen. Prednnisone is not recommended for long term use because of the known serious side effects that most patients experience sooner or later.

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Replies to "Thank-you for sharing this information. It is always interesting how other countries treat their medical conditions...."

Thank you for your reply, you raise some interesting points. I fully agree with your' statement 'In my opinion, the "pain symptoms of PMR" respond to prednisone but the "PMR condition" does not.
The taper plans that most pmr patients use in the UK are the result of years of trial and error by patients. The ones I quoted are just two of a number that seem to work well for a majority of people. Doctors in the UK follow government guidelines on drug availability to prescribe. The standard for pmr is prednisolone, 15mg for 4 weeks, 12.5 for 4 weeks then reducing 1mg every month. I have never heard of anyone achieving that reduction. A large percentage of our Doctors think that pmr goes into remission in 2 years, I think that is what they are taught when training. After saying that, many Doctors here are ok with the patient reducing as tolerated without the time element.
Biologics are expensive in the UK so are generally not available on the National Health Service, apart from patients with rheumatoid arthritis. I assume some private patients could access them.
Many years ago I came across a patent in China for a herbal remedy for pmr. The research paper was based on just under 100 patients. 94% were in remission after one year without relapses, the other 6% took a little longer.
Good to hear that you are now in a pmr free zone, enjoy !

I used Dexamethasone. Medicare drug plan did cover. I am not sure if its similar to Rayos but it works quicker and lasts longer. Its about 5 to 6 times stronger than prednisone so you need to adjust the dosage accordingly. I had no trouble with tapering off. My PMR lasted about 6 months and I was off.