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He is much more concerned about my ability to get off Prednisone than Kevzara, and he views the side effects and long term risks of Prednisone as much more likely and more destructive than Kevzara. In his view, Kevzara's risks are serious but very infrequent. Comparatively, Prednisone 's risks are more numerous and more common and also quite serious.
Replies to "He is much more concerned about my ability to get off Prednisone than Kevzara, and he..."
My rheumatologist said basically the same thing. I thought he had me confused for someone else when he said I was "too young" and "too healthy" to take prednisone for the rest of my life. I was 65 years old but I felt much older --- over 100. I took prednisone for 30 years already but daily for PMR for only 12 years. I didn't think the remaining years of my life would be very long.
Actemra gave me a new lease on life after I was finally able to taper off prednisone. My chronological age is how I currently feel. I'm 70 but getting to 90 seems feasible but 100 might be pushing it. I feel healthier as evidenced by 10 other medications in addition to Prednisone I have also stopped taking. Time will tell but I don't have the steroid burden or PMR anymore as long as I do a monthly Actemra infusion. The following study was funded by Genentech but other studies suggest the duration of PMR/GCA treated with Prednisone is much longer than 2 years.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7991019/
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"The higher-than-anticipated number of patients with continued disease and exposure to glucocorticoids at 2 years suggests a more chronic nature of GCA and PMR in this real-world study rather than the existing expectation that GCA and PMR often resolve within 2 years of therapy. These results highlight the need to consider a potential long-term disease course in patients with GCA and/or PMR and for the use of efficacious, glucocorticoid-sparing therapies in these patients.
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Now my rheumatologist says it is clear that my overall condition is much better on Actemra. The turnaround happened within a year of getting off Prednisone. I had forgotten what it was like to really feel good again and not needing Prednisone every day.
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My rheumatologist feels exactly the same way. I have had PMR for 3 months and unable to taper to less than 20 mg per day without significant flares. Starting on Kevzara as soon as I get back to NJ from the Florida sun.