1. < Polymyalgia Rheumatica (PMR)

Does anyone have AFIB which makes steroid therapy an issue?

Posted by apheiff @apheiff, Oct 27 1:10pm

I have persistent AFIB & diagnosed with PMR & perhaps GCA. Steroids act quickly on the symptoms but at the dose required causes AFIB. I was diagnosed 6 weeks ago after over a year of agony & an unnecessary hip replacement. My main symptoms are exhaustion / fatigue with hip & shoulder stiffness after being seated or sleep. I have started Actemra 4 weeks ago with no noticeable results to date. Each time I try to ramp up steroids above 8mg I have anxiety/ heart issues, but I seem to need 10mg minimum to get sleep / relieve stiffness. Any ideas?

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DadCue | @dadcue | Oct 27 4:42pm

I never had a problem with a-fib but Prednisone can certainly cause a-fib or make it worse.

Actemra might be an ideal medication for you. I was unable to taper off prednisone for more than 12 years after PMR was diagnosed. I had cardiovascular side effects from Prednisone. Actemra got me off Prednisone but it took time. It took me about a year to go from 10 mg to zero after Actemra was started. I noticed an improvement in my PMR symptoms in about 3 months. My rheumatologist says any biologic should be given at least 3 months to see if it will work for you or not.

I have been off Prednisone for almost 4 years. I still need a monthly infusions to Actemra to control my PMR symptoms. I don't have any concerning side effects from Actemra. Not only was I able to stop Prednisone, I was also able to discontinue five of my cardiovascular medications that were treating Prednisone side effects.

I sincerely hope Actemra will work for you as well as it does for me. You need to give Actemra some time to work because it doesn't work immediately like Prednisone does.

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1 reply
aznurse58 | @aznurse58 | Oct 28 9:14am

What dose of Prednisone are you on?
Anxiety pushes AFib for sure. Do you take anything for that?

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1 reply
jenbillig | @jenbillig | Oct 28 10:34am
In reply to @dadcue "I never had a problem with a-fib but Prednisone can certainly cause a-fib or make it..." + (show)
@dadcue

I never had a problem with a-fib but Prednisone can certainly cause a-fib or make it worse.

Actemra might be an ideal medication for you. I was unable to taper off prednisone for more than 12 years after PMR was diagnosed. I had cardiovascular side effects from Prednisone. Actemra got me off Prednisone but it took time. It took me about a year to go from 10 mg to zero after Actemra was started. I noticed an improvement in my PMR symptoms in about 3 months. My rheumatologist says any biologic should be given at least 3 months to see if it will work for you or not.

I have been off Prednisone for almost 4 years. I still need a monthly infusions to Actemra to control my PMR symptoms. I don't have any concerning side effects from Actemra. Not only was I able to stop Prednisone, I was also able to discontinue five of my cardiovascular medications that were treating Prednisone side effects.

I sincerely hope Actemra will work for you as well as it does for me. You need to give Actemra some time to work because it doesn't work immediately like Prednisone does.

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I seem to be one of the few ones that ACTEMRA did not work. I developed severe itching and my joint pains actually increased. My Dr recommended that I stop it and I am back on 5mg prednisone. Doing great but puzzled as to why ACTEMRA did not work for me.

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apheiff | @apheiff | Oct 28 10:41am
In reply to @aznurse58 "What dose of Prednisone are you on? Anxiety pushes AFib for sure. Do you take anything..." + (show)
@aznurse58

What dose of Prednisone are you on?
Anxiety pushes AFib for sure. Do you take anything for that?

Jump to this post

Actually Dr switched me to methylprednisolone. It is 20% stronger per mg so 16 = 20 prednisone. I took 16 for 2 days, which caused Afib, went to 8 for 2 days, now at 6mg. Anything more helps PMR symptoms, but pushes toward Afib. The anxiety is usually a precursor to an Afib occurrence.

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1 reply
aznurse58 | @aznurse58 | Oct 28 11:10am
In reply to @apheiff "Actually Dr switched me to methylprednisolone. It is 20% stronger per mg so 16 = 20..." + (show)
@apheiff

Actually Dr switched me to methylprednisolone. It is 20% stronger per mg so 16 = 20 prednisone. I took 16 for 2 days, which caused Afib, went to 8 for 2 days, now at 6mg. Anything more helps PMR symptoms, but pushes toward Afib. The anxiety is usually a precursor to an Afib occurrence.

Jump to this post

This may not be a healthy response, but my cardiologist told me to take an extra dose of flecainide when this occurs.
Might be worth asking about.

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navymom154 | @navymom154 | Oct 28 1:40pm

Slightly off topic but, I had AFIB for 5-6 years (way before I developed PMR). I was on flecanide and other drugs and had 3 ablations. At one point a nurse practictioner suggested I have a sleep study done. I discovered I had severe sleep apnea was fitted with a CPAP and have not had an episode of AFIB since, (it's been seven years!) I've had PMR for three years and continue the seesaw-ing of taking pred after 2 flares.........but, at least no AFIB! I wish you well!

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