I have GCA and PMR diagnosis Nov 2024 . Immediate start on 50mg pred rapid taper and weekly Actemera 162mg subcutaneous weekly. I too was concerned about pred side effects. The worst I experienced was insomnia when on high dose . I had some other side effects such as minor raise in blood sugars, and blood pressure. No fluid retention, no moon face , no weight gain. I was quite strict with low GI diet , low salt diet. This probably helped.

I’m now off prednisone completely, all done in 3 half months . Blood sugar and blood pressure returned to normal. No problem with my bone density either. For further bone scan later this yr .

I was in full remission according to my blood results and zero symptoms within 2 months of treatment.

Now I’m on Actemera as a mono treatment for one year.
No side effects so far, just a slight cholesterol increase. Not a problem since my cholesterol has always been on the low side anyway.
Rheumatologist says any relapses would be treated with Actemera, no more prednisone
Thank you modern medicine made it all manageable.
Actemera has been effective for me and saved me from high cumulative doses of damaging pred .