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I was diagnosed with PMR in September of 2024 and with GCA in November of 2024. Symptoms improved with Prednisone 50 mg. daily and I have now tapered to Prednisone 20 mg. daily without relapse. My rheumatologist strongly recommends Actemra and I truly do understand based on how I feel on the Prednisone. However I am so frightened of starting Actemra as I also have COPD, oxygen dependent with activity, and I really don't want to get a respiratory infection. I am aware that Prednisone also increases my risk of infection and I have just basically stayed home since these diagnoses other than Dr. appointments. I also have a history of a CVA for which I take Aggrenox, osteoporosis for which I have had a Reclast infusion, hypertension and hyperlipidemia. I had been walking slowly with oxygen on my treadmill for 30 minutes daily when I was diagnosed with GCA and I have slowly increased my walking to 45 minutes twice daily since then. So I am getting my exercise. I am wondering if anyone else currently on Actemra has COPD? Thank you for any insight.
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The safety profile of Actemra alone is probably better than prednisone alone. The difficulty is Actemra may not allow you to get off prednisone. You could wind up being on both prednisone and Actemra for a certain amount of time simply because prednisone can't be stopped abruptly.
Prednisone suppresses your immune system and increases your risk of infection. Actemra suppresses your immune system and increases the risk of infection. I had a tendency to get infections whenever I took prednisone in combination with any other medication that suppressed my immune system. My rheumatologist would say "too much immunosuppression" caused the infection instead of saying prednisone caused the infection or the other medication caused it. She said it was the combination of both medications.
Unfortunately, COPD increases your risk of a lung infection. I can understand your concern about adding Actemra to the mix. I don't know what you should do. Doctors face tough medical decisions all the time. That is why I never wanted to be a doctor.