How does Kevzara help with PMR symptoms and pain? I am being weaned

@joyl263
I did respond to it. The first day was amazing. I was pain free for the first time in months. The second day was also good and I slept 9 hours instead of the 5-6 I was before pred. By day 3 it was reducing the pain significantly but not eliminating it. I'm on day 4 now, having taken my pred two hours ago. My pain is significantly reduced but not gone. I don't know if I'm expecting too much or not.

@kjoed53 I didn’t know your heart beat rate had increased, along with glucose (expected, mine has increased too but my PCP and rheumatologist seem ok with my level.) Somehow, my blood pressure has improved (my eyesight too, weird, I know) it had always been a bit high but now is in the normal range, go figure.

This is a bizarre disease!

If you can’t tolerate the pain, I’d up the Prednisone dosage for a few days to try for some relief. I could barely move and the pain kept me from sleeping. PCP started me on 40mg/day.
If you can tolerate the pain, (and there are some out there trying to outlast it taking nothing but Tylenol/Ibuprophen cocktails) stay on the lower dose and continue to manage the side effects.
For me, side effects are the new norm.
I wish you the best of wishes and luck k’53. Keep letting us know what you decide and how you are doing. We are all learning about PMR, including the doctors. God bless them.

@stonewheel

I had multiple blood clots in both of my lungs that were documented as a massive pulmonary embolism (PE). The event was called "unprovoked" and I was told that I was lucky to be alive. I heard whispering outside my ICU door about prednisone being a factor for why I had such a massive PE. Did your doctors say prednisone might be a contributing factor for your blood clot?

I usually say "long term" prednisone increases the risk of side effects. I'm beginning to think that "short term" prednisone isn't any better.
https://www.uspharmacist.com/article/shortterm-corticosteroids-increase-risk-for-range-of-conditions
I guess the overall risk is still very low but when a patient is one of the "unlucky ones" to have a serious side effect then the overall risk doesn't matter.
--------------------------------
I remember a self proclaimed "expert" on another forum saying that prednisone side effects are easy to manage. Obviously that expert never did patient care in a hospital.

It was also said that if I needed Prednisone for the rest of my life that was okay if it improved my quality of life. My life could have been shortened by 20 years when I had the PE. I have to admit my quality of life was pretty good on prednisone up until I had the PE.

Since my PE was so massive and unprovoked, I was told I would need to be on warfarin for the rest of my life. I took warfarin daily for about 15 years along with all my other cardiac medications.

A few years ago I was evaluated to see if I could switch to Eliquis instead of warfarin. I told my doctors that I was on high dose prednisone at the time of my PE but Actemra allowed me to taper off Prednisone. I was already off all my other cardiac medications. That was when it was decided that I didn't need any blood thinning medication anymore. Warfarin was stopped so my treatment wasn't lifelong. I have been able to survive 3 more years without warfarin and I haven't had any blood clots.

@dadcue Drug risks are a percent of hundreds to thousands of people who will have a specific problem. I am a mathematics major and 25 years ago when m breast surgeon quoted me my chance of recurrence - I looked her in the eye and told her my personal chance is either 0% or 100% - that no one has a percent of a medical problem. I look at the list of drug side effects the same way - either you have it or you don't. I make treatment decisions with that in mind.

@kjoed53 This is when you need to understand the half-life and the steady state of a drug. The half-life is the time it takes for half of a single does is eliminated from your body. The rule of thumb is that it take 5 half-lives for a drug to completely be eliminated from your system.
Steady state is the concept of the balance of drug in your system achieved between taking a dose and the elimination of the drug by the body, resulting in a stable concentration of the drug in our body.
The half-life of Kevzara is 8-10 days and the steady state is achieved 28 to 50 days after your first dose. Meaning sometime during your second month you will achieve steady state. Until you get to the steady state each dose you take means you are getting closer - once at steady state the amount of drug you eliminate naturally between doses is equal to the amount of drug you take in a single dose.
Hope this helps you set expectations and better understand how drugs work.

@dadcue Drug risks are a percent of hundreds to thousands of people who will have a specific problem. I am a mathematics major and 25 years ago when m breast surgeon quoted me my chance of recurrence - I looked her in the eye and told her my personal chance is either 0% or 100% - that no one has a percent of a medical problem. I look at the list of drug side effects the same way - either you have it or you don't. I make treatment decisions with that in mind.

@jabrown0407
Sounds reasonable to a degree, but if you base all medical and health decisions on either a 0% or 100% outcome, you are limiting your options and optimism, aren't you?

@jabrown0407
Sounds reasonable to a degree, but if you base all medical and health decisions on either a 0% or 100% outcome, you are limiting your options and optimism, aren't you?

@jabrown0407
Thanks for the explanation. I'm guessing that you're saying to stay patient and eventually I'll get to the point where the meds are being maximized in my body and I will feel the full relief that they are capable of providing.

@kjoed53 I didn’t know your heart beat rate had increased, along with glucose (expected, mine has increased too but my PCP and rheumatologist seem ok with my level.) Somehow, my blood pressure has improved (my eyesight too, weird, I know) it had always been a bit high but now is in the normal range, go figure.

This is a bizarre disease!

If you can’t tolerate the pain, I’d up the Prednisone dosage for a few days to try for some relief. I could barely move and the pain kept me from sleeping. PCP started me on 40mg/day.
If you can tolerate the pain, (and there are some out there trying to outlast it taking nothing but Tylenol/Ibuprophen cocktails) stay on the lower dose and continue to manage the side effects.
For me, side effects are the new norm.
I wish you the best of wishes and luck k’53. Keep letting us know what you decide and how you are doing. We are all learning about PMR, including the doctors. God bless them.