If the PMR is still active and you keep tapering, at some point the symptoms of PMR will become active again. I think of prednisone like a blanket that smothers flames. The embers keep burning under the blanket, and if you take the blanket away, the embers flare back up. In most people PMR burns itself out in a year or two, but it can last longer.

"What happens if people quit the methotrexate or kevzara but keep tapering the prednisone? Anyone know?
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Probably nothing changes ... You just keep trying to taper off Prednisone and hope you don't have a relapse and side effects from long term prednisone use.

I stopped methotrexate because of elevated liver enzymes and nausea. Methotrexate was helping me decrease my Prednisone dose but I hated the retching I had every morning. When I stopped methotrexate, I had to increase my Prednisone dose again.

I don't have any experience with Kevzara. My rheumatatolgist wanted me to try Actemra instead.

Actemra has been a blessing. I tapered off prednisone relatively quickly compared to the previous 12 years. I regret that Actemra wasn't offered to me sooner because I had so many relapses when I tried to taper off Prednisone. I didn't mind the relapses as much as all the side effects from Prednisone. My experience with 12 years of long term Prednisone use was an insidious downward spiral of my overall health and well being.

Prednisone is still used for rapid initial symptom control. However, the goal of "modern treatment" is to shift patients to alternatives to prednisone to avoid the severe long-term complications of prednisone.

I had what is called "relapsing PMR" when I tried to taper off Prednisone. On Actemra, I have had 5 years of sustained remission with no relapses. Actemra has also improved my quality of life compared to when I took Prednisone. There is a reason why alternative medications to treat PMR are called "steroid sparing medications."