Treating PMR with Prednisone and Hydroxychloroquine

I have been taking hydroxychloroquine for 18 years for another autoimmune disease, but it did nothing for the PMR pain. Same thing with methotrexate. But, it might help for you, each medication works differently on different people.

@lindaadel
I encourage you to suggest a biologic to your rheumatologist. I’m on a monthly infusion of Actemra along with a daily dose of 5 mg of prednisone (down from 15 mg three months ago). My inflammation markers have dropped to normal, and my PMR pain has been replaced with the normal aches and stiffness of a senior citizen. Next month I’m going to begin tapering off of the prednisone. I believe the Actemra made the difference.

I tried Methotrexate and reacted badly but many others find it helpful. Hydroxychloroquine has worked for me with no discernible side effects and at a relatively low dose. I had quite severe PMR and it has dramatically lowered my CRP inflammation score over 6 months of taking it. I have been able to steadily decrease the Prednisone dose, now at 3.25mg (plan o be at zero by xmas), pain levels are managed with a couple of Paracetamol a few times a week. As with all these drugs, it takes a few months to start working. My Rheumatologist said I will probably need to keep taking it for at least 2 years. I think I can get off it much sooner by keeping up the AI diet and exercise regime.

@lindaadel, you have received some helpful replies to your question about treating PMR with hydroxychloroquine. Additionally, I moved your question to this existing discussion so that you can review previous comments and connect with other members:
- Treating PMR with Prednisone and Hydroxychloroquine: https://connect.mayoclinic.org/discussion/treating-pmr-with-prednisone-and-hydroxychloroquine/

Has your rheumatologist suggest that hydroxychloroquine might work better for you?

Just another note on Hydroxychloroquine. My understanding is that it is an immunosuppressant, just like Methotrexate and Leflunomide but not as strong and therefore better tolerated by those with drug sensitivities. Dose is based on your weight, I started on half the recommended dose because I am very sensitive to medications, started noticing within about 6 weeks that it was helping with the Prednisone reductions. I bumped it up by 100mg on one occasion over the last 6 months when it felt like the PMR was flaring and it helped me avoid increasing Prednisone. The main side effect of concern is irreversible changes in the retina of the eye but this only happens when you've been taking it for about 5 years. I like the fact that the low level of immune suppression allows my natural immune system to continue functioning. Have healed well after minor skin surgery and respiratory illnesses. It gets a thumbs up from me.

Thank you so very much Colleen I appreciate all of your help!!!

I have a rheumy appointment this week. I’m now on 6 mg of prednisone but the pain is lasting longer in the day instead of just mornings. The doc has me on a taper of 1 mg every 2 weeks. I wonder if that’s too fast. I’ll talk about adding hydroxy. Can you share your tapering schedule?

2mg a month when you're down to 6mg is a very fast taper.

I have been on hydroxychloroquine for 20 years, and I have never had any kind of side effect. It has worked wonders with APS, and has helped with PMR for the last two. I have my eyes examined every year for changes but so far, so good. It is a drug I will take for the rest of my life without fear of damage.

I’m on prednisone and currently at 5.5mg. I’m in pain in the mornings and much better by afternoon and evening. When I saw my rheumatologist last week we went over methx and leflunomide. After reading about hydroxy here on this thread, I decided I wanted to try that. My doc said she’s never prescribed it for her Pmr patients but for lupus but said if I wanted to try it, so be it. She has me on 200 mg every other day and 400 mg every other day bc she said I should be on 325mg a day. It’s only been 5 days and it’s my understanding it could take up to 3 months to kick in. Here’s hoping.