@visnu

Your rheumatologist isn't wrong about what he says. There is nothing wrong about the protocol. It more closely represents the "textbook protocol" for how to treat PMR. However, there isn't a single best way to treat PMR and not everyone has a textbook case of PMR.

Likewise, the duration of PMR varies widely. Sometimes "remission" can be achieved in a few months and sometimes remission can take years. It isn't correct to say that prednisone "cures PMR." Prednisone does not cure PMR, but it helps to relieve the painful symptoms until PMR goes into remission.

After PMR goes into remission then we slowly taper our Prednisone dose lower until we reach the "lowest effective dose of prednisone." The lowest effective dose also widely varies and depends on many variables.

Whenever my prednisone dose got too low, there was always the danger of a relapse. Relapsing PMR was why I needed to take Prednisone for more than 12 years. My relapses had nothing to do with how I tapered my prednisone dose. There isn't one single best way that any research says is superior to all the other ways of tapering off prednisone. Anyone who claims to know the "best way to taper off prednisone" is deceiving you. However, the general rule is to taper off "slowly" which conflicts with the general rule to taper off Prednisone "as soon as possible."

In the USA, relapsing PMR is now being treated more often with a biologic called Kevzara (sarilumab) which is a monoclonal antibody medication used to treat moderate to severe polymyalgia rheumatica (PMR). It works by blocking interleukin-6 (IL-6), a cytokine that plays a role in inflammation.

For GCA, a different biologic called Actemra tocilizumab) is frequently used. The biologic Actemra (tocilizumab) is frequently used and is the first FDA-approved treatment for adults with giant cell arteritis (GCA). Actemra also blocks the IL-6 cytokine which is implicated in both PMR and GCA.

Doctors in the USA have the belief that the risks of "long-term" prednisone use outweigh the "short-term" benefits of prednisone. I think European doctors also believe this to be true. This is why all doctors universally want us off prednisone as soon as possible.

Fortunately there is research being done to enable us to get off Prednisone faster. There are other biologic treatments for PMR/GCA that are being researched. It only took me a year to taper off Prednisone after Actemra was tried. There weren't many options except for Prednisone when I was diagnosed with PMR nineteen years ago. Better options are currently available.
https://www.healio.com/news/rheumatology/20250220/tsunami-of-effortbrings-biologics-to-the-forefront-in-giant-cell-arteritis-pmr