Connect
← Return to PMR and prednisone
Discussion
Comment receiving replies
I am assuming there will have to be a balance between tolerable discomfort vs prednisone dose. Without having my first rheumatologist appointment I'm trying to educate myself to help level set my own expectations. I've read 1 to 2 years to get this manageable or into remission? My nature is to rush things, but I'm already sensing this will be different and nothing will be rushed/forced. I am planning to take this one day at a time.
Replies to "I am assuming there will have to be a balance between tolerable discomfort vs prednisone dose...."
@mwhite6262
I have GCA and PMR. I started treatment a year and a half ago, and I haven't had any pain or other symptoms since I started treatment. It's interesting that with GCA, there's no debate about tolerable discomfort vs prednisone dose. If you're having discomfort with GCA, there is a strong risk that something really bad could happen, like losing vision or having a stroke. You definitely want your GCA to be well controlled. PMR is less risky, but it can still cause damage if it isn't controlled.
Connect
@mwhite6262
One to two years is the time frame when rheumatologists get "uncomfortable" that their patients are still taking prednisone. This is when "steroid sparing" medications are introduced. It is the "cumulative dose" and "duration" of prednisone use that becomes concerning.
While the aim is to stop prednisone as soon as possible, the average duration of treatment with prednisone to treat PMR is approximately two years. However, for some people, the duration of treatment is much longer. I was treated with prednisone for 12 years! That outcome isn't something to strive for ... believe me.
The following is a good summary that is research based.
https://www.keele.ac.uk/nhs/healthimpactinthenews/2022/may/keele-research/polymyalgia-rheumatica-treatment.php
-------------------
My PMR was called refractory and characterized by frequent relapses. After 12 years of prednisone my rheumatologist decided I was "too young" to take prednisone for the rest of my life. Treatment with a biologic medication instead of prednisone was tried ... then I was able to taper off prednisone in 1-2 years. Now I have been off prednisone for 5 years. My treatment with a biologic is ongoing without all the side effects of prednisone.
Long-term treatment decisions should be personal decisions made with your doctor's help while taking into consideration the adverse effects associated with prolonged prednisone use. Some examples are osteoporosis, diabetes, mood disorders, adrenal insufficiency and other adverse effects.