← Return to GCA (Giant Cell Arteritis) and PMR (polymyalgia rheumatica)
DiscussionGCA (Giant Cell Arteritis) and PMR (polymyalgia rheumatica)
Polymyalgia Rheumatica (PMR) | Last Active: Oct 25 10:20am | Replies (277)Comment receiving replies
Replies to "I've had PMR for almost one year and am now trying to get below 7.5 mg..."
Hi @norieaugustine, PMR and GCA are "companion systemic inflammatory disorders". In the U.S., the annual incidence of PMR is 52.5 per 100,000 in patients aged 50 and older. The incidence and prevalence of GCA are approximately one-third those of PMR (Cecil and Goldman's Textbook of Medicine). I found an article online, "Treatment of Polymyalgia Rheumatica" in Up to Date which stated that, "The initial dose of prednisone needed to alleviate musculoskeletal symptoms in PMR is lower than used to control vascular inflammation associated with GCA. Treatment has not been shown to improve prognosis or prevent progression to GCA." So whether PMR advances to GCA seems to be out of our control. I have both. The pain and stiffness of PMR were terrible and affected my whole body from the neck down. With GCA, I had a couple of disruptions to vision in my right eye, occasional short stabbing or pulsating pains from my right ear to my eye which increased over time, a tender scalp, and the worst stiff neck ever, with pain on both sides of the back of my head. I went undiagnosed for a year, largely my own fault, because I thought I had fibromyalgia. A mild case of herpes zoster, even after having the Shingrex vaccine a year prior, and anemia brought it all to light through a consult with an infectious disease specialist. My rheumatologist put me on a low dose of prednisone, about 10 mg, then increased it to 40 mg after hearing my symptoms and ordering a temporal artery biopsy which was positive for GCA. My mother-in-law had temporal arteritis, diagnosed in her 80s and she lived to be nearly 100. My maternal aunt also had it. I am managing very well now, down to 7.5 mg of prednisone. One thing for anyone with GCA, my Rheumy told me to take a low dose of aspirin every day as those with GCA may develop aortic aneurysms down the road. I'm thankful these disorders can be managed with prednisone and so far the tapering has been going well. Now I just have to take care of my bones! My suggestion is to try not to worry about getting GCA too much, as it's out of your control, but watch for the signs and report them to your doctor immediately if you get them because the consequences of untreated GCA are stroke or blindness. Best to you.
I should have mentioned these discussions also as they might be helpful for tapering off of prednisone.
-- PMR Dosages and Managing Symptoms: https://connect.mayoclinic.org/discussion/pmr-dosages/
-- Prednisone tapering is hard: Do complementary therapies help?: https://connect.mayoclinic.org/discussion/prednisone-tapering/
-- Tapering off of Prednisone: https://connect.mayoclinic.org/discussion/prednisone/