@brightwood I started on 60 mg of Prednisone in July 2024 for GCA/PMR. While I was tapering, I got down to 9-10, I had a flare (Dec. 2024). I started on Actemra infusions in January 2025. I was able to taper to 0 in November 2025, with no issues. I felt so much better after a couple of months on Actemra. The only side effects so far, is that it lowered my WBC and I easily get respiratory illness (although I mask up in crowded situations). I don't have any pre-existing conditions as you do. I went the infusion route, as my Part D doesn't cover Actemra self-injecting dosing.