1. < Polymyalgia Rheumatica (PMR)
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When to start titrating down

Posted by villager @villager, 4 days ago

Newly diagnosed PMR. ESR 74 and CRP 120. Started on 20mg prednisone 10 days ago. Had follow up blood work today. Won’t know results for a couple of days. Excruciating pain gone with just minor pain/stiffness in a.m. I know the ACR guidelines recommend lowering the dose after 2-4 weeks. Is 2 weeks too soon or should I wait 4 weeks for best results?

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tweetypie13 | @tweetypie13 | 3 days ago

Things to consider, age, exercise level, other health and meds.
Keep a journal of daily pain level, dose, exercise to help evaluate
My experience has been that….
Not more than 10% taper
Taper Timing is up to Dr.
this blog and myself seem to say……4 weeks….
Prednisone helps reduce the inflammation and PMR inflammation does not go away in a quick amt of time.

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jeff97 | @jeff97 | 3 days ago

Your blood values are very high. My ESR was 54 and my CRP was 9 when I was diagnosed with GCA and PMR, I stayed at my beginning dose of 60 mg of prednisone for 6 weeks. I agree with @tweetypie13 that 4 weeks is better, It's better to be too slow as opposed to too fast. Tapering too fast can cause flares and adrenal issues at lower doses.

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stonewheel | @stonewheel | 2 days ago

Hi. Everyone is different, has different experiences, lab numbers, starting doses, maintenance doses, tapering time schedules, and even symptoms. I learned that here. We also have common symptoms, that’s how we know what we have, of course.
I learn here what possibilities are ahead and basic questions to ask my doctors, including the tapering off Prednisone, biotic, treatments and that I am not alone.
I wish you the very best.
Good luck.

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