The longer you stay on prednisone, the longer it takes to get off. It mostly depends on how quickly the adrenals recover.
I never got past the 7 mg barrier without the biologic I presently take. The biologic controlled my PMR inflammation without suppressing my adrenal function. After the biologic was started, I blew right past the 7 mg barrier down to 3 mg.
My endocrinologist said I needed to be on 3 mg of an "extended period of time" and hope my adrenals would start to produce some cortisol. I had withdrawal symptoms but they weren't as bad as my PMR symptoms were originally. I kept telling myself I wouldn't have a PMR flare because the biologic had that part under control.
My endocrinologist wasn't too optimistic about the chances that my adrenals would recover since I was on Prednisone for 12 years. She said the adrenals usually recover but 12 years was a very long time to be on Prednisone. It took about a year for me to have an "adequate" cortisol level. When I had an adequate cortisol level, my endocrinologist said from 3 mg to zero no tapering was needed. I did a 3 mg - 2 mg - 1 mg -zero countdown taper in a week and I was suddenly off Prednisone.
I had to stay on 3 mg for a year! That would have been impossible for me to do without the biologic. I have now been off prednisone for more than 3 years but I still do a monthly infusion of the biologic. My side effects from the biologic are minimal if any. I had terrible side effects from Prednisone. I would rather not need the biologic but it works better than Prednisone for me without all the Prednisone side effects.
I sometimes feel like I cheated with taking a biologic. I was prepared to take Prednisone for the rest of my life except my rheumatologist didn't like that idea.
I currently don't have a rheumatologist as mine moved back to Florida in May. The only other practice anywhere close to me can't see me until October. I'm having some vision problems that I'm hoping are just age related and a simple matter of bifocals. Not, hopefully, GCA. Before he left, my rheumie talked about starting me on Kevzara. I have my 3 month checkup with my PCP next week and an appointment with an ophthamologist. Planning to ask my PCP about a scrip for Kevzara. My side effects with the Pred are honestly awful which it sounds like you can relate to. Thanks so much for your valuable input!