How fast. Is taper? What % drop, and hold at that for how long?
Supplement with Tylenol for arthritis, 2 in morning, and 2 at bedtime if need be.

Have you tried Kevzara? It can take several months to take effect, but it works very well for some people. I take a similar drug, Actemra, and I'm completely off prednisone and don't have any symptoms of PMR or GCA.

After 5 years of Prednisone with relapses there is more than enough justification to try a biologic. Kevzara is the logical choice for PMR alone. If GCA or vasculitis is involved, maybe Actemra is now the best alternative to Prednisone. There's even more justification to try a biologic if methotrexate doesn't work. Regardless of what you try next ... you will still need to continue prednisone until an alternative is found. Research and medical guidelines support a gradual tapering approach of Prednisone to allow the body's adrenal glands to recover, especially after long-term use.

Other than a slow and gradual taper of Prednisone, there is no evidence based taper plan that works the best for everyone.

What’s the largest dosage of Methotrexate you e taken?

Hello @sastrep,

I combined your discussion into an existing discussion on tapering off prednisone and methotrexate titled:

"Weaning off of all medicine - prednisone and methotrexate"
- https://connect.mayoclinic.org/discussion/weaning-off-of-all-medicine-prednisone-and-methotrexate/

@rl24 started this discussion and you have met @dadcue here as well. I'd like to also invite @rwerky and @ill back as well.