Hello @mikeshell, Welcome to Connect. I think it's always a good idea to review your treatment options with your doctor or rheumatologist, especially given you mentioned having a history of not being able to tolerate prednisone. There is another discussion that you might find helpful.

Actemra (Tocilizumab) to treat PMR??: https://connect.mayoclinic.org/discussion/actemra-tocilizumab-to-treat-pmr/

@kimh, @mgrogers, @tsc and others may also have some thoughts or suggestions based on their experience with PMR.

Do you mind sharing which side effects of prednisone concern you the most?

Thank you for the information. Initially, my main concern is the effect prednisone has on my stomach and the fact that if I don't eat a substantial meal, my stomach hurts, and I'm concerned ulcers will develop. The feeling of heightened anxiety and restlessness is hard to manage. I always feel very much on edge. I also have 6 cardiovascular stents and I'm concerned prednisone will cause plague buildup and/or rigidity in my arteries. Prednisone also can reduce the effectiveness of Metoprolol (which I currently take) and I have been unable increase the dosage of Metoprolol because it causes skin rashes, etc. I know there isn't a magic bullet to fix this condition; I'm hoping to find a solution that is less intrusive to limiting my active lifestyle. Thank you very much for your thoughts or suggestions. As this is a new disease for me, I'm really trying to learn as much as I can to help me make educated choices.

Hey mikeshell,
After dealing with a great deal of discomfort in my upper legs and upper torso for a number of months, I was eventually diagnosed with PMR in July 2020. I received almost immediate relief from a 20mg dose of prednisone and started a 10-month taper. Fortunately I experienced only minimal side effects from the prednisone (mostly some weight gain). Near the end of my taper, some of the discomfort returned, but not nearly at the level I had experienced earlier. About a month after weaning off the prednisone, I began to experience mild headaches and some jaw discomfort. After doing some research, I decided I should see a rheumatologist, made the appointment, and within days was diagnosed with Giant Cell Arteritis in June 2021. At that point I started another 10-month prednisone taper and also began receiving monthly infusions of Actemra. If you would like to connect with others in your situation, I would also suggest you visit: https://www.vasculitisfoundation.org