GLP-1 Drugs Effects on PMR

@cwbf
The Progress Report Promised on May 11: Mounjaro works. Kevzara works. I recommend both.

As a 6 foot tall 83 year old male, I gained about 30 pounds on prednisone, topping out at 252. With the help of Kevzara, I began to taper from prednisone, reducing at the rate of 1 mg a week at the advice of a board certified rheumatologist at Vanderbilt, and was able to terminate prednisone on May 31, hallelujah. I began Mounjaro on May 12 and have now lost 28 pounds, weighing 224 this morning, August 24. My CPAP readings recently have been from 1.5 to .5, all time lows for me.

Whether it's daily stretching exercises, Kevzara or Mounjaro, I feel less stiff. That combination has been successful for me, although I certainly recognize that Kevzara and Mounjaro are expensive without insurance.

My doctor prescribed me, Repatha since my cholesterol was up to 331. I’ve had two injections so far no side effects whatsoever just kind of at the initial injection site the next day. I’m also on Wegovy. I just started that today and I’m down to 6 1/2 mg of prednisone. I never thought I’d be taking so many different drugs I’m 68 and I’ve always been very healthy and physically active. I recently had a fall at the grocery store and fractured my elbow and my humorous that sent me back a little bit, but now I’m starting to be able to swim and go to the gym again. Things happen for a reason. I just wish I knew what they were.

@jabrown0407
Thanks for your info - very useful. I was diagnosed with PMR in May 2026 and of course, started on prednisone ASAP with fab results. But then within 5 days came the multiple side-effects of the pred! I am now taking over 6 medications to counteract the side-effects! Makes me question the reason we tolerate the prednisone!

Anyway, the prednisone caused extreme hunger, so my doc put me on a course of peptides called retatrutide - the newest GLP drug. And, although it causes extreme stomach pains (common with GLPs) I have lost 3 pounds in three months. Not at all what you would expect from this drug, but it is keeping the extreme weight gain caused by the prednisone at bay.

I was ordered (and approved) Kevzara in July, but having difficulty getting the Specialty Pharmacy to actually process and send it! That is supposed to start later this week so I can start prednisone tapering. Every time I try to do that, my body rebels and I go back to PMR symptoms or full-on adrenal insufficiency (like sleeping 20 hours out of 24!!)

I am hopeful the Kevzara will also help so I can get as far away from prednisone as possible!

Grateful for you post and would love to hear from others with this type of experience

I came down w PMR 24-36 hours after first covid shot. Mild. After the booster I had major PMR. Started at Mayo a month after that as no one knew what this PMR was. Mayo had on high dose prednisone for 9 months but tapered down to 10 and Mayo would not prescribe anything else. So I switched to a Rheumatologist locally in St Paul MN and he tried hydroxychloriquin for 6 months. And no taper on prednisone still at 10. Gained 37 pounds at this point. I had CPAP BEFORE COVID. So cardiologist internist rheum and pulmonologist ok’d Zepbound. Lost the weight. My CPAP numbers for events after Zepbound dropped to 2-3 events per hour from 25-30. Amazing. It’s the zepbound that did that. I’m at maintenance dose of 2.5 Zepbound but I really think this glp does more that just help weight loss or my sleep apnea. Still on 2 mg of prednisone and I have no intention of lowering it. Still same weight but if I watched it a bit more than I do I would likely lose more weight but I eat normal and don’t ever overdo it. Hope that helps.

@randersonccc

When on the timeline was Actemra started?

Why not try zero prednisone if PMR is controlled? Was your cortisol level ever checked?

Because, if I do no prednisone I get the GCA headache. Seeing new rheumatoid arthritis in a month. What blood tests do you suggest I request? No cortisol done yet. And I started Actemra about 9 months ago. As I have been at this for over 5 years I have done tapers many times. If I go below 2 mg after 5 days the right temporal HA begins then it takes 3 days with a higher dose of prednisone and then taper to 2. Sorry but not worth the HA and re-managing this awful condition. I’ve learned a lot from this site and everyone’s contribution. But I think about it and as I’m 78, how much more quality time do I really have? I’m a very positive and optimistic person but also realistic. But I continue to keep moving and do participate in many activities. And for me—no more vaccines of any kind.

@randersonccc I've been struggling with PMR for 10 years and on 5mg Prednisone daily. Every time I try to taper off I relapse and it takes months to get back in pain control. So I'm specifically interested to know if you think GLP-1 helps with PMR muscle pain & stiffness?
A woman in my dance class was scheduled for hip surgery but wanted to lose some weight before and got on GLP-1. She discovered all her hip pain went away - she thought it may be from the weight loss but when she got off the GLP-1 3 weeks later the pain returned. She now takes GLP-1 once every 3-4 week and is pain free. I'm very interested to see if it help with PMR as I'd love to taper off the prednisone. The future looks promising. Thanks.

@zendaysahead I've been on a GLP-1 on and off (mostly on except for a three-month break) for almost three years. I have had various muscle, joint, and nerve issues before and during that time. I have never felt that the GLP-1 had any effect on my pain/stiffness levels. (Terrific for suppressing appetite and increasing fullness, though, as advertised.)

I was officially diagnosed with PMR 3 months ago, but my best guess is that I had it for at least two years before that. Of course, that's just me and my mix of issues.

On a related topic, both my primary and my rheumy feel that a GLP-1 and prednisone are a good fit. I've read a few articles that say the same, and a few that sort of casually disagree, but haven't done a deep dive yet.

Good luck.

I had been talking to doctor about Zepbound for sleep apnea previously, so when my weight suddenly went up after being on prednisone for 4 months, I started on Zepbound to try and get BMI below 27, which it did. Did not notice any effect on PMR in the past 7 months of Zepbound, currently on 10mg Zepbound.

I did lose the weight I gained on prednisone (17 pounds in 4 months) and am slowly losing more weight at about 1 pound a week, but way slower than others have reported. Doctors think the Zepbound basically cancels out the prednisone increased appetite. But during the increases in Zepbound and the tapering of prednisone, PMR symptoms stayed the same until I got to 5mg prednisone and had a PMR flare and had to go back up to 7mg. Just started methotrexate today.

My husband started Mounjaro a year ago for high sugar readings. Lost 50 lbs. now still 6’ but 170 lbs now. Anyway PMR started 8 months later. Don’t know what to make of GLP-1 and PMR.