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Typical dose of prednisone for PMR
Polymyalgia Rheumatica (PMR) | Last Active: Sep 2 7:20am | Replies (39)Comment receiving replies
My take and response to @maryjanecowell
1. A rheumatologist is not necessary for treatment
2. A GP or primary care can treat this (mine did) and has treated many others. Rheumatologists are hard to come by in the US and especially in the rural US
3. Wait times for any specialist are criminal in this country (USA) and either a month or 11 months is obscene. Nix the Rheumy
4. PMR can be but is not a lifelong condition. For most it is not.
5. PMR is NOT an autoimmune disease. There are no specific antibodies associated with it as a disease like RA. It is an immune modulated disease.
6. 40 mg to treat PMR is NOT a starting dose unless GCA is believed to exist and that is diagnosable with a high resolution picture of the eye by a Doctor of Optometry. Biopsy of arteries is controversial and dangerous.
7. Protocols for tapering and original dose are available papers such as the one below. An international meeting in 2015 set up standard treatment protocols. https://www.ncbi.nlm.nih.gov/books/NBK537274/.
8. Biologicals such as Kevzara should be considered as adjuncts to prednisone
9. The longer you wait to treat and get on with the plan the more pain your husband will be in . Pain is a waste of time and there is some belief/research(?) that says the longer you go undiagnosed and treated the harder it is to get over PMR and the longer you may have to be on prednisone.
10. Prednisone sucks but it does work for the vast majority of PMR people. Get on it, get feeling better and then follow the taper. Good luck
Replies to "My take and response to @MaryJaneCowell 1. A rheumatologist is not necessary for treatment 2. A..."
@petermccarville really appreciate your post. I am a “list maker” too. Your answers make sense-just hope we can get our GP to 👍 thanks
@petermccarville
Obviously the GP is not familiar with PMR or they would not prescribe the course of prednisone as if it was a short term issue. I would not recommend treatment by any doctor not familiar with PMR.
@petermccarville love this post.. I’m just starting out on the journey after suffering for only about 3 weeks of the intense pain. 20mg initially got rid of my symptoms in one day. Luckily in UK i managed to see a very good Rheumatologist within a couple of weeks and he used 20mg to make the diagnosis as my bloods were normal. Now on 15mg for one week and then 12.5 and then 10mg for a period of one month to five weeks ( that’s the plan) … I’m 58 so apparently on the younger side to have this so I’m hoping that my quick diagnosis and general good health will help me taper in the way you described. I’m still very worried though and know that this can be complicated… thanks again for great post
@petermccarville
That link is spot on. I wish I had seen it a year ago when I was being diagnosed.
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@petermccarville
There is I believe one other way to diagnose GCA, which is with "Color Doppler Ultrasound" also called "Power Doppler Ultrasound," or "Musculoskeletal Ultrasound. " It also can confirm PMR by looking at the shoulder. The Ultrasound Dr had to look at both my temples and sides of my head and maybe somewhere else I can't remember to check for the GCA. It's not like a regular Ultrasound and might need special training by techs, I'm not sure. Just in case no one knows about it. Don't know how easy they are to get in rural areas as mentioned though.
Unfortunately, in my experience, regular Dr's, NP's often have never heard of it, encountered it nor be very knowledgeable about dosing and tapering speeds etc. But every Dr is different. I hope everyone can get the help they need. This is a terrible disease.