Has anyone had a PMR flareup and still had low Sed rate

Looking for anything to help with PMR. Put on Prednison for yrs ago. Started with 20mg and 1 mg at night. Over 3 years got down to 6 & 1. In Aug '21 PMR worsened. Have been on 15mg in AM and 15mg at night. Continue to try and lower. Had 5 straight nights w/o pain and then while on the same dosage, the morning pain came roaring back. No luck with slow release Pred.

CONSIDERING ACUPUNTURE. Anyone have experience with that? Thanks MIKE

Hi, kvd9. Maybe someone's already mentioned Methotrexate as an alternative to Prednisone. Methotrexate is most often prescribed with folic acid. I finally got an appointment to see a Rheumatologist for my PMR, scheduled for this afternoon, and I plan to ask about Methotrexate as an alternative. Good luck to you.

I met with my Rheumatologist yesterday, and she said methotrexate is not particularly effective for PMR as an alternative to Prednisone.

Hi everyone, This is my fourth episode of PMR 1n 10 years - groan. For my last session in 2018 I had difficulties in weaning off prednisone and the methotrexate seemed to help. I've attached a graph which shows on the X axis 'time since onset' and the Y axis shows the values. It shows that each time I tried to decrease the prednisone I had an increase in pain. The medical text "UptoDate'" has this to say about using methotrexate to help reduce prednisone "Data from randomized controlled studies on the efficacy of MTX as a glucocorticoid-sparing agent are mixed, though generally favorable results have been reported with regard to cumulative glucocorticoid doses, relapse rates, and time to discontinuation of glucocorticoid treatment [42,43]. Interpretation of a negative controlled study on the use of concurrent MTX is limited by a high dropout rate [44]. These data, however, are limited by several factors including the small number of patients studied and by the relatively low doses of MTX used (in the range of 7.5 to 10 mg/week) compared with contemporary doses (in the range of 20 to 25 mg/week). Also, no study has demonstrated an actual reduction in glucocorticoid-related adverse events in MTX-treated patients compared with patients treated with glucocorticoids alone." For my present episode, I've started again on methotrexate to hopefully reduce the total time on steroids - keeping my fingers crossed! However, the methotrexate does require monitoring and frequent blood tests. Oh, and booze not allowed 🙁 Hope this helps.

Hello John and thanks for the feedback. Yes, indeed lifestyle and diet changes are so important, actually essential. I already had a healthy lifestyle but I needed to be even more vigilant with my lifestyle as it was hampered by the limitation of activity (initially) and the effects from prednisone (with weight gain). One source of excellent advice was from Kate Gilbert's book "Polymyalgia Rheumatica and Giant Cell Arteritis"

The graph is simple to make with an excel spread sheet. For my graph the headings for the various columns were 1) Days since onset 2) pain (peak) levels out of 10 3) prednisone (mg taken). 4) methotrexate (mg taken). In a more recent graph, I added a "T 1/2" column which represented the time to decrease to 50% of the peak pain level. I found that the graph was very useful to share with my physicians. For this recent episode, I started at 15 mg of prednisone, but had to increase to 25 mg to control the pain. At present, I'm at 15 mg with the weaning off process and I'm at 4 months since the onset. Taking 15 mg methotrexate pills. Since the main side effect of methotrexate (for me) is fatigue and drowsiness, I switched from a morning dose to the evening - works better. Hope your journey goes well.

Thank you for this informative site!
I have PMR since end of May. I am tapering down to 3 pills 2.5 a day.
Doctor wants me to prescribe RX for bone loss. I have read the side effects and I would rather have a fracture than these side effects. Your thoughts?

Thank you
mpm

I can’t give you any help. But, I came down with PMR within 2 weeks of my second booster. Doctors don’t like to confirm that the shot and the onset of PMR were related.

Actemra
Maybe.