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"Evolution" of Seronegative RA into PMR

Polymyalgia Rheumatica (PMR) | Last Active: May 30 8:30pm | Replies (31)

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@dadcue

Sorry ... I don't advocate for prednisone at all. I would want people to discontinue taking prednisone as soon as they can. Has your daughter been diagnosed with polymyalgia rheumatica (PMR)??? Why was prednisone started in the first place?

I don't have RA so I don't know exactly how people with RA progress to other options.. As far as I know, methotrexate is one of the first things that is tried. Few if any doctors want their patients on long term steroids but in the short term Prednisone works well. The long term side effects of prednisone are a real problem. The instant gratification of pain relief is a positive reinforcement to continue taking prednisone. However, prednisone isn't the miracle that people think it is. The real miracle only happens when people can discontinue Prednisone.

There are arguably cases of people having an "addiction" to prednisone but mostly people just want something that reliably relieves their pain. While prednisone itself is not addictive, some people who use it over an extended period may develop physical dependence. Physical dependence means that the body has adapted to the presence of the drug, and abruptly discontinuing its use can trigger the presentation of withdrawal symptoms and/or adrenal insufficiency. Trying to stop taking prednisone can be worse experience than the condition being treated ... I think.

People treated for PMR/GCA are started on prednisone and are told they will need it for a year or two. It is like a miracle because the pain is relieved quickly and reliably. Prednisone does improve their "quality of life" in the short term. However long term use of prednisone caused a deterioration of my quality of life. The struggle I had was finding something that relieved the pain when I attempted to stop taking prednisone. Methotrexate hasn't been shown to be as beneficial to PMR sufferers as it has been for RA sufferers.

When methotrexate doesn't work for people with RA, they have other options.

When methotrexate doesn't work for people with PMR , there aren't many alternatives.

I was willing to try any alternative to prednisone because I knew prednisone wasn't good for me in the long term. People tend to not be open minded to alternatives simple because there aren't many alternatives to Prednisone for the treatment of PMR. I was fortunate that a biologic worked for me. I have been off Prednisone for 3 years and counting and my quality of life is improving.

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Replies to "Sorry ... I don't advocate for prednisone at all. I would want people to discontinue taking..."

Great summary of where the thought of stopping prednisone has taken her. I know some regular old addicts and alcoholic, and your comment about people getting addicted to pred rings true. It seems akin to someone offering to run over you with a truck and is asking you to agree with enthusiasm…reading about you RA folks is making me grateful for my crippling (literally) knee OA. You get no press like like the killer diseases (e.g.cancer) but it deserves a bigger awareness profile, doesn’t it? Brave folks…