Anyone successfully treating PMR without Prednisone?

Posted by ann31 @ann31, Jul 25 1:44pm

I am in severe pain with soreness aching in shoulders, upper back, both hips and now headache. I am starting to get some numbness in both hips. I was treated for GCA several years ago starting at 60mg prednisone. Within 6 months I was down to 5mg then a flare so doctor put me back up to 80mg but quickly got me down to 20mg. I continued tapering over the following 6months then off. I had some lasting side effects and watching for in infections from dental work so I am very fearful of taking Prednisone again. This came on gradually over the past month. I called my Rheumatologist to ask if Plaquenil or Methotrexate would hep but he insist this is from long standing Fibromyalgia due to labs normal for inflammation. I can barely walk, stand up or turn over in bed. Taking 400mg Gabepentin daily as Dr recommends. No help. I have never had this severe pain from Fibromyalgia. My husband came down, suddenly, with PMR about 10 years ago with symptoms like I now have. His gradually cleared with Plaquenil and Methotrexate. Has anyone had success treating this type pain with OTC meds such as Omega or Bromelain or anything else?

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

@trina24

I have been on Actemra Infusion
For almost 1 yr. It has helped. No Predisone. Theresa

Jump to this post

Excellent!

REPLY

3months prednisone taper post Large Vessel GCA/ PMR diagnosis Nov 2024 . ( no more Pred since End Jan 2025)

Nov 24 Simultaneous commencement of Actemera 162mg subcutaneous weekly.

Remission achieved within a month , nil symptoms or discernible side effects so far 9months in .

Expect to cease Actemera Nov 2025 .
ie 12 months Actemera treatment.

PET scan done this week all clear . Recent Blood work showed Inflammation markers normal / low .

A relatively easy ride so far . I’m well aware of the possibility of relapse though.

REPLY
@nm11643

I was prescribed 15mg/day for my PMR. Even though I only took 10mg/day prednisone considering my 105LB body weight, I could not sleep for the first three days. So I had to reduced it to 5mg/day in order to get a few hours sleep every night. It took me 18 month to get out of prednisone. During those days, I always feel some discomfort, especially in the morning. I took some anti inflammatory supplements and always be mindful about what I eat.

Jump to this post

What were the anti inflammatory supplements you took? Thanks.

REPLY
@pike01

I’m down to 12.5 prednisone and also methotrexate. Will soon be trying KEVZARA. We’ll see? Anyone try it to get off Prednisone and
Methotrexate?

Jump to this post

Search these threads for Kevzara.
I’m happy with it. Almost 3 wks off prednisone. No side effects. Use Tylenol for arthritis as needed.

REPLY
@pike01

I’m sorry that I don’t know how to edit my last comment. So, is anyone on KEVZARA and are there any issues trying to come off of it?

Jump to this post

I’m starting kevzara Aug 6
I’m at 2mg pred . I would love to hear more about kevzara

REPLY
@dadcue

It was a long 12 year journey but now PMR is being treated without prednisone. I started out with Prednisone when PMR was first diagnosed. After 12 years of Prednisone with many relapses, I have been off Prednisone for almost 5 years. Prednisone was coupled with various conventional DMARDs but I still had relapses.

I am now being treated without Prednisone. I took a multifaceted approach to get off Prednisone. I had to realize that not all pain was PMR even though Prednisone helped me cope with a wide variety of pain.

First I decided to have my knees replaced because knee pain was originally a sports injury in high school. I was told my knees had advanced osteoarthritis before the age of 30.

A more difficult problem was trigeminal neuralgia. That face pain had nothing to do with GCA even though Prednisone did a decent job controlling the pain. I gave up on tegretal, gabapentin and all those other medications for nerve pain. The neurologist was right all along because Prednisone wasn't the best solution either. The trigeminal neuralgia pain became incapacitating to the extent that I couldn't even speak while my face was being electrocuted for hours at a time. After a couple of emergency room visits, a sophisticated MRI scan was warranted. The MRI scan revealed what might be causing the trigeminal neuralgia pain. It wasn't completely clear what the problem was but a neurosurgeon went in to take a look and found the problem. The neurosurgeon said prednisone was probably helping the swelling and inflammation in the area near my brain stem. The neurosurgeon was able to stop the electricity to my face.

After surgery for trigeminal neuralgia, I had another setback. It was the lower back pain that I had felt hundreds of times. That pain was always relieved with Prednisone except this time it included neurological changes that were hard to ignore. Another MRI revealed the cause was severe spinal stenosis. The spine surgeon wanted to do emergency spine surgery except for the 60 mg of Prednisone I took to relieve the pain. I didn't think I would have survived a lumbar fusion after having knee replacements and a craniotomy for trigeminal neuralgia in the same year.

The surgeries I had allowed me to reduce my Prednisone dose substantially but only down to 10 mg. That was when I contemplated taking prednisone for the rest of my life. Fortunately, I became virtual friends with a person on the internet who had an adrenal crisis. She had no reason to help me except for saying she was in a coma for 6 months and was "sent back." She wanted to spare me her fate with an adrenal crisis after I told her how long I had taken Prednisone. She said I needed to preserve whatever adrenal function I had left.

I mentioned things about adrenal insufficiency to my rheumatologist who didn't take it too seriously at first. However, at a subsequent visit an option was presented to me as my best chance of ever getting off Prednisone. The option was Actemra (tocilizumab) for relapsing and refractory PMR. Within a couple of months, I was down to 3 mg but I was ordered to remain 3 mg when my cortisol level was too low. I was then diagnosed with prednisone induced adrenal insufficiency and referred to an endocrinologist.

An endocrinologist helped me overcome adrenal insufficiency. Within one year, I was off Prednisone except I subsequently had a flare of uveitis which necessitated 60 mg of Prednisone again. A different biologic was used to prevent uveitis flares while Actemra was stopped.

Uveitis was soon in remission again except that PMR relapsed. My rheumatologist said it would be impossible to adequately treat everything so I was asked what I wanted to do. I wanted to be off Prednisone so Actemra was restarted.

I have now been successfully treated with Actemra with no Prednisone for almost 5 years with no relapses of PMR or anything else. Sorry for such a long story.

Jump to this post

Hi,
Wow...you've been through it! Thanks for taking time to share your story. It scares me to think what's ahead for me. I was dx with PMR on June 5th and have been on prednisone 15 mg since. I started Kevzara and have had 2 doses. Now I will start tapering prednisone. I hope to hear more about everyone's experiences. It's so helpful. Thank you again.

REPLY
@janiceellen

I’m starting kevzara Aug 6
I’m at 2mg pred . I would love to hear more about kevzara

Jump to this post

I will be on it soon. Probably about the same time? Heard good reviews but I’d like to know if you can stop it without tapering down? Im on 10-12.5 mg prednisone and methotrexate

REPLY
Please sign in or register to post a reply.