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Weaning off of prednisone & pain management
Polymyalgia Rheumatica (PMR) | Last Active: Oct 25 10:23am | Replies (156)Comment receiving replies
I saw my rheumatologist on Monday. When I first went to her I loved her. At my Monday appt. I felt she was brushing off some of my concerns. So I was disappointed. Anyway, she wants me to take my 2.5mg dose of prednisone for a couple of weeks and then go every other day. After a couple of weeks, she wants me to quit prednisone completely. She also wants to change my Kevzara injections to every 3 weeks. This seems a little quick to me. I will try her orders but I'm afraid I will have a flare. I still have stiffness in my shoulders and arms. Any thoughts would be appreciated from this great group of people! BTW my blood markers come back normal.
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I understand why doctors want us off the Prednisone ASAP, after being punished by it for my severe contact of PMR flairs. Initially I thought Prednisone was the Cat's Meow. I felt better than I can recall over the past 3 years or more. Then side effects set in and I wish I would have known the Prednisone effects. Along with doctors, I totally agree to get off that is never too soon. The damage long term is literally deadly. My bloodwork initially was normal for the PMR specific tests, but way off for blood sugars, white count and more. Isn't it aggravating to visit our doctor to notice they seem to not realize the chronic painful discomfort we are in? If only every doctor during initial training had to personally experience the disease or malady they treat; perhaps it would be a better world?
Best wishes with your riddance of Prednisone.
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I don't have any experience with Kevzara. I have taken Actemra for PMR for a long time. Kevzara and Actemra are similar and worked basically the same way. Both Kevzara and Actemra are both IL-6 inhibitors.
I can tell you that it took me about 6 months to taper from 10 mg down to 3 mg of Prednisone. I had to stay on 3 mg of Prednisone for another 6 months because of adrenal insufficiency. I was referred to an endocrinologist who I still see because of side effects from long term Prednisone use. My long term Prednisone use was 12 years.
The duration of prednisone use impacts how soon you may be able to taper off Prednisone. This is due to adrenal insufficiency and also whether or not PMR is in remission. If your adrenals don't recover very soon, you may have a need to continue replacing cortisol with Prednisone.
When my cortisol level improved, my endocrinologist said I could stop taking Prednisone. She said no tapering was necessary from 3 mg to zero as long as my cortisol level was adequate.
I did a fast taper from 3 mg to zero in a week or two. I understand your reluctance to taper too quickly because doing a "slow taper" was all I was ever told to do. However, I was able to discontinue Prednisone quickly once my cortisol level improved and PMR was in remission. Both things need to happen!