The lowest effective dose, how is it defined?

I started on 15mg and stayed there for about 2 months, and slowly reduced to 7mg, only started getting severe pains again. By the 3rd day on this level,
I had to increase to 9mg. After a month, reduce by 1mg, then another 1 mg a month later. But oh no, the pain came back worse than before, so I am sticking to 9mg for a long time. So far, it has been 6 months, and plucking up the courage to reduce again by another 1mg for a while yet.

@kare1
Replying to myself! I’m now on 1.5 mg pred. It’s taken me a year to get here from last August 2025 4 to 5 mgs.
I don’t know what to think.

@kare1 Everyone is on a different schedule. Some people need treatment for a really long time. My brother-in-law is at about 15 years of methotrexate for his PMR. I'm at more than 2 years of treatment for GCA and PMR, and it looks like it will last another year. I didn't expect treatment to last that long.

@kare1

You're making great progress! You are doing much better than I was doing after a year and a half. You must be doing something right. I doubt anyone will say you are tapering too fast or too slow. I don't think you have been on prednisone for too long.

I took Prednisone for 12 years so can't say I was tapering very fast either but it probably was too long. I was stuck on 10 mg for about 5 years. Things can become more complicated the longer you are on prednisone. At the dose you are on, it should not cause too many problems.

I was diagnosed with PMR in July 2024 and Sjogren's December 2024. I am presently taking a daily dose of prednisone of 5 mg. Occasionally I have to increase it to 6-7 depending on the weather and how much pain I have. I'm 80 and will probably be on this the rest of my life. Living without the pain is worth it to me.

We can only determine the lowest effective dose for ourselves. The lowest effective dose is the dose that gets you to the amount of pain you're willing to tolerate. Whether that's pain free, mild or moderate only you can decide that.

@jeff97 thanks for your response! When I saw how long I had to get to the 1.5 I was shocked & a little sad! I too thought I’d be off this sh*t in a year (totally underestimated PMR). I asked Rheumy when I could kick methotrexate out of my life after dumping prednisone & he said 6 mo after. Ug. I do have bilateral hip pain every morning but it’s not awful (sitting too long does annoy it more). But the mild pain calms down through the day. Typical PMR. Next week I’ll drop to the alternating 1 & 1.5 schedule. Here goes…
Good luck to you & your bro-in-law!!

@dadcue oh thanks for the positive feedback! Nice to have the support here as I felt deflated after seeing how long I took weaning. I did a very slow drop of pred as I had read here. Alternating for a few weeks as I dropped by .5 mgs. Come to see it’s taken me a year?? Yikes. At a few mgs higher no hip pain but I’m not going back up. It’s quite acceptable aches. Last blood test showed SED rate had increased from 14 to 22 which is the wrong way for it to move & borderline anemia!
Not sure if it’s lazy food intake or the meds prednisone/methtrexate? I don’t know what I’ve done to be able to lower to 1.5 - I’m a lazy vegan I don’t drink or smoke and I get outside everyday & walk. Love the birding too. That walking in nature is addictive & I really really have to have it daily! Mental health is huge part of treating this chronic crap.
Well, y'all enjoy the last day of summer. I can see the season is changing!