@cheraloha

I think the "difference" is how how much faster you can taper down and hopefully off prednisone. For newly diagnosed PMR patients who have not started Prednisone, Kevzara might take 3 months to become fully effective. In order to "feel a difference" when a patient is already on Prednisone is more difficult because Prednisone should be controlling their symptoms.

The 3 months talked about is steroid-free, remission often documented around the 3-month (12-week) mark in clinical studies. These clinical studies tend to select "newly diagnosed PMR patients."

What isn't mentioned very often is 3 months to be "steroid free" is dependent on how long a person has been on Prednisone. The longer a person has taken Prednisone it becomes harder and harder to taper off prednisone. This is because of prednisone induced adrenal insufficiency. Some people may develop permanent (irreversible) adrenal insufficiency and they might never be able to taper off Prednisone. Fortunately, irreversible secondary adrenal insufficiency from long term Prednisone use is relatively rare.

I was on Prednisone for 12 years and it took me more than a year to taper off the first time and close to 2 years to become completely prednisone free. I had to stay on a 3 mg dose of Prednisone for more than 6 months just waiting for my cortisol level to improve.

Some of the symptoms I felt on lower doses of prednisone were caused by adrenal insufficiency and they weren't exactly PMR symptoms. However, symptoms of adrenal insufficiency and PMR can feel the same.

According to artificial intelligence:
"Adrenal insufficiency (AI) and Polymyalgia Rheumatica (PMR) share overlapping symptoms—notably extreme fatigue, muscle pain/weakness, and joint pain—making them difficult to distinguish, especially during steroid tapers."