"I’ve noticed on this forum that everyone just seems to be on prednisone and no other medication"
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This is true when someone is first diagnosed with PMR. Prednisone is the "first line" treatment for PMR.
After 6 months to a year, doctors start to introduce other medications when someone isn't able to reduce their dose and taper off Prednisone. Not being able to taper off prednisone becomes a big problem because of the side effects when prednisone is taken long term. Even when someone is able to taper off Prednisone initially, people are prone to have relapses of PMR. When a relapse happens, Prednisone is restarted along with other medications to prevent future relapses.
I started with prednisone and no other medications when I was first diagnosed with PMR. During my 12 years on Prednisone my medication count increased to about 15 medictions but most of those other medications were treating Prednisone side effects.
Methotrexate, Leflunomide and several different NSAIDS like ibuprofen, Celebrex, Naproxin and others were used to try to reduce my "steroid burden" as it is sometimes called. Steroid burden is the amount of corticosteroids a person takes over time and the associated health effects. My steroid burden was massive during my 12 years of treatment with prednisone for PMR. I had other autoimmune disorders along with prednisone side effects to contend with in addition to PMR.
A long time ago, sulfasalazine was also tried. It is known as a disease modifying anti-rheumatic drug (DMARD). It was used for one of my other autoimmune conditions but it isn't commonly used for PMR. My rheumatologist wanted to try it for PMR when she was reading my ancient medical records that I had a "good response" to sulfalazine. I told her "my recollection" wasn't what my medical records said. When I told her what I remembered about sulfasalazine, she decided it probably shouldn't be tried again.
https://rheumatology.org/patients/sulfasalazine-azulfidine
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I have been off Prednisone for the last 5 years. I'm now being treated with a biologic DMARD that is working well for me. Biologic DMARDs are another class of medications used to treat inflammatory conditions. They are distinct from conventional DMARDs like methotrexate, leflunomide and others.
Not only did I get off Prednisone --- I have also been able to discontinue about 10 other medications that were treating Prednisone side effects.
Thank you for your reply ☺️ it’s certainly a journey. I keep close to my heart the saying “ This too shall pass “ and hope it’s just the two year span that I’ve read the duration is , fingers crossed.