Hi John,

I've been reading through some of these threads on PMR. I wish I had found this forum sooner! I wanted to share my experience and see if you have any advice for me. I was diagnosed with PMR in July 2017, after an acute onset. I'm 62, and I couldn't walk or sleep from pain (hip area, upper arms).

I started prednisone at 40 mg, because I had also had some headaches, and the doc had me biopsied for GCA (negative). The prednisone worked within hours. I quickly came down to 20 mg. I had trouble getting below that, and the doctor added methotrexate to the mix, after which I got down to 10 within a couple of months. Now, it has been 3 more years, and I'm hovering at 5 mgs, still with the methotrexate (injections, because I for some reasons didn't metabolize the oral form). My CRP has been extremely hard to reduce. It was in the 60s on diagnosis, and the lowest reading I've ever had was an 8. It has been gradually rising since that reading, and now stands at 18.

When I try to lower the prednisone, I get a bit achy, but not too bad. The main thing is that my CRP seems to rise. If I were weaning based on symptoms alone, I would probably be down to 2 or 3 mgs by now, or even lower. (Last spring, when Covid hit, my doc had me go off everything for some reason, and after 6 weeks I had a huge flare that put me in bed for a week, so I know I can't just go cold-turkey.)

My real question is: should I pay attention to the CRP, or should I just focus on symptoms and try to get off the prednisone anyway? I know you are not a doctor, but I want to know whether the numbers or the symptoms are the main guiding factor, in your opinion.

I should mention that I have two complicating health issues. One is that I am now obese (thank you, prednisone), which I know contributes to inflammation. And I have another mildly inflammatory illness (but which never put my CRP this high). It's possible the high CRP is something cumulative going on.

Thanks for any thoughts you can share!