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Tapering Pains Body Response or PMR?

Polymyalgia Rheumatica (PMR) | Last Active: Jun 25, 2024 | Replies (13)
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@art43

I definitely agree with you that there is no “best way”, but…all other factors being equal…the people on here tapering more quickly or chasing a bouncing dosage ball also seem to be the ones having more issues. You published an excellent summary a few days ago on tapering considerations that should be required reading for everyone, starting with the requirement that unless PMR is definitely in remission, forget about trying to taper until it is.

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Replies to "I definitely agree with you that there is no “best way”, but…all other factors being equal…the..."
DadCue | @dadcue | Jun 25, 2024

I don't know how to control "all other factors being equal." I don't think it exists in the real world of medicine.

I remember trying to enroll patients into experimental research studies. Finding the "perfect patient" was like trying to find a needle in a haystack. Exclusion criteria had to be followed. The goal was to eliminate "confounding variables."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3503514/
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I don't know if a faster taper would be better compared to a slower taper. The need for a slower prednisone taper is because of the withdrawal problems and adrenal suppression from long term Prednisone use. I'm not sure if it is something inherent to PMR.

I just wish for more alternatives to long term Prednisone for the treatment of PMR.

For me at least, I wish Actemra had been tried much sooner than it was. I can't blame anyone because it wasn't an option. Technically Actemra still isn't an option for PMR but it is for GCA.

I tell people I used to be able to taper off Prednisone quickly. My ophhalmologist said I was "skilled" with Prednisone tapers for uveitis.

I was terrible at tapering off prednisone after PMR was diagnosed. I generally think the people who get off Prednisone quickly after PMR is diagnosed are more skilled than me.

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