"None of these drugs work on helping to restart your cortisol."

I mostly agree with this. However, I think IL-6 inhibitors "indirectly help" the problem with adrenal insufficiency. The only thing that "directly helps" the adrenals is to maintain a lower dose of prednisone for an extended period of time. When I was stuck on 10 mg of prednisone, my endocrinologist said there wasn't anything that would help with adrenal insufficiency as long as I needed that much prednisone. A prednisone dose of 3 mg or less was what my endocrinolgist said was needed before my adrenals would begin to respond. She said I should come back to see her when I could stay on 3 mg of prednisone for an "extended period of time." Taking only 3 mg of prednisone seemed impossible to me at the time.

My endocrinologist referred me back to my rheumatologist to see if my prednisone dose could be lowered. Another year elapsed before Actemra was suggested to me. I don't think my rheumatologist cared that much about my adrenal function. My rheumatologist just said I was "too young' and "too healthy" to take prednisone for the rest of my life. I thought he was joking about me being young and healthy because I was 64 years old and I rated my health as poor.

In any case, my rheumatologist told me about Actemra a year after I saw the endocrinologist. I was interested in a biologic but I only knew about TNF inhibitors like Humira. My interest in TNF inhibitors was because of being diagnosed with reactive arthritis and uveitis. TNF inhibitors are used for both of these conditions rather than long term prednisone. My rheumatologist said there were 2 possibilities for biologics that I could try but he wanted me to try Actemra first. He didn't say what the 2nd option was but I later learned it was Humira.

Reactive arthritis and uveitis weren't active. My medical records only said I had a "history of" both of these conditions. Reactive arthritis and uveitis were a distant history and thought to be in remission and/or cured after I started taking prednisone every day. PMR was thought to be my primary problem and that was what prednisone was treating.

I didn't really want to take Actemra mostly because I had never heard of it. I was hearing bad things about Actemra. Other people were saying there was nothing wrong with taking prednisone for the rest of my life. It was all about the "quality of life" prednisone was giving me which seemed absurd to me. I wanted off prednisone more than anything because of what I had learned about adrenal insufficiency from the person who had the adrenal crisis.

Without going into details, Actemra allowed me to quickly taper down to 3 mg. My rheumatologist ordered me to stay on that dose because of a low cortisol level. I was referred back to the endocrinologist who took over my prednisone prescription. My endocrinologist told me what I needed to do but mostly I needed to stay on low dose prednisone. Only when my cortisol level improved did she tell me to discontinue prednisone.

Since Actemra allowed me to maintain a low dose of prednisone for six months until my cortisol level improved, I tend to think Actemra helped me indirectly with adrenal insufficiency. Actemra didn't suppress my adrenal function like Prednisone did.

BTW, as soon as I got off Prednisone the first time, I had a massive flare of uveitis. Actemra was stopped by my opthalmologist who said Humira was the optimal treatment for uveitis. Humira might have worked for uveitis except my PMR symptoms returned. That was when my rheumatoloist gave me the choice between Humira or Actemra but not both. I chose Actemra instead of Humira.