Polymyalgia Rheumatica (PMR), prednisone and Coronavirus COVID-19

Hi @kathylovgren, I see that your previous post with a similar question was moved by @colleenyoung to the following discussion. Did you get a chance to read through the discussion and find answers to your question?

> Groups > Polymyalgia Rheumatica (PMR) > Polymyalgia Rheumatica (PMR), prednisone and Coronavirus COVID-19
-- https://connect.mayoclinic.org/discussion/coronavirus-and-pmr/

I haven't seen any PMR specific information for COVID-19. Mayo Clinic has a webpage dedicated to COVID-19 that has a topic for how to reduce your risks.
-- https://newsnetwork.mayoclinic.org/discussion/reduce-your-covid-19-risk-wash-hands-clean-cell-phones-and-workstations/

Did you see the new Group added to Connect for COVID-19? It has a lot of discussions that you might find helpful during this stressful time.
-- https://connect.mayoclinic.org/group/covid-19/

Mayo Clinic News Network has a page on COVID-19 that is continually updated with helpful information, podcasts and question and answer topics.
-- https://newsnetwork.mayoclinic.org/category/covid-19/

When flare up of pmr occurs what should one do in face of Covid 19 and worries about it versus autoimmune response? Go back on prednisone at low level or what?

Hi @kathylovgren, you may have noticed I moved your post to this discussion that @johnbishop had referenced you post being put before so that you can connect with others with similar experience. Simply click VIEW & REPLY in your email notification to get to your post.

I encourage you to read through the other posts in this discussion and also to look through the references John shared. How have you been feeling? Have you been able to send a message to your doctor to ask their opinion?

I am a hospital pharmacist. My thought is that low-dose 1 mg would not significantly alter your immune response to a virus. I’m currently on 10 mg and I think that could have an effect. But I appreciate all the comments on this. I’ve just been that much more cautious to prevent what we can.

A few weeks ago, I specifically asked my rheumatologist about Prednisone and PMR. Obviously it is a complicated question because PMR is a disease that results from an overly aggressive immune system. While the trigger is usually unknown, it is known that the adrenal glands produce too much cortisol (often but not always confirmed by blood tests). Prednisone at higher doses shuts down the adrenals, thereby reducing cortisol and “shutting down” the immune system. One of the reason to taper Prednisone is to gradually bring the adrenal glands back to work. At lower doses, probably 20 mg a day or less, (I found one study done in Europe that confirms that) the adrenals are back working (hopefully) so your immune system should be working normally by the time you wean off it. At 10 mg a day or less, you clearly are not at higher risk for Covid-19 by reason of Prednisone ingestion. HOWEVER, everyone is different and many of us have other risk factors, particularly age. So all posts encouraging social distancing and hand washing are right on as we don’t want to find out what a combination of Covid-19 and PMR will be like. (Caveat: i am not a doctor, but rather a lawyer with enough medical knowledge to be dangerous, so discuss with your provider) .

Hello @pfafpa, Welcome to Mayo Clinic Connect. Thanks for sharing your experience with PMR. I've had PMR twice but it is currently in remission. I fall into the high risk group due to age and a few different autoimmune conditions so I'm trying to do my due diligence to maintain social distancing, washing my hands and all of the other tips being shared.

Are you currently on prednisone for PMR?

Hi, John. Yes, I’m currently on 3 mg of Prednisone, down from 40 when I was diagnosed in January of 2019. Twice before I had flares at 3 and had to go higher, but I’m doing well this time (6 weeks). I’ve had some odd side effects from the medication but PMR is well managed. I’m fortunate. Thanks for reaching out. I just discovered this group after following one in the UK for a year or so.

Hi @pfafpa ! I would say you are a lawyer with good instincts. My immune system is a bit wobbly too plus I’m old so I take the advice very seriously. That’s the best we can do!

This post contains the answer I have been looking for since Covid-19 appeared. That at less then 10 mg a day ...are not at higher risk. So thanks for that. I will stick with my 2 g a day now and be able to do my laces up. Of course as you say there are many other risk factors each individual may have, but its one thing less to worry about. I like your comment about being a lawyer. It reminds me of my husband, who was a research chemist, in the way both professions have people who question and delve away at an issue or problem, and never rest until they find their answer. He was a danger to medical staff at times … at least his questioning drove them mad lol.

Hi @pfafpa. I'm happy you are doing well and have not had any flares over the last 6 weeks. You mentioned that you had some odd side effects from Prednisone. My grandfather experienced mood changes and other things, but I'm not sure of his dosage. If you are okay with sharing, what side effects have you experienced?