← Return to PMR with hand/wrist pain and swollen veins?

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@connelly

Continuing from preceding comment…..
Advice from my rheumatologist:
1. Inflammatory markers normal over recent months.
2. Continue monthly 1mg tapering from current 7mg to 2 or 3mg daily. Return for assessment in 4-6 months.
3. Wrist and knee pain suggests incipient rheumatoid arthritis. These symptoms are not a usual consequence of PMR but PMR is often a precursor to RA. My current absence of joint swelling, soreness to touch or loss of joint mobility may only mean that these symptoms of RA are masked or avoided by my current high 7mg daily Prednisolone dosage.
4. These RA symptoms/afflictions may develop as I continue to reduce Prednisolone dosage.

This was bleak advice. Rheumatologist justified it on two grounds:
1. As a healthy 82 yr old with a 5-10 year life expectancy continuance on Prednisolone at anything above 2 or 3 mg daily dosage will result in a range of serious effects, disabilities, miseries. Complete elimination is best;
2. If Rheumatoid Arthritis does develop, there are better therapies than Prednisolone.

As a matter of interest, I also have a relatively benign form of Dupuytren’s contracture. Together with PMR, this is a double whammy for my rogue Scandinavian genes. Other than the Scandinavian connection, PMR and DC seem to be unrelated conditions.

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Replies to "Continuing from preceding comment….. Advice from my rheumatologist: 1. Inflammatory markers normal over recent months. 2...."

Thank you for sharing, though not what I want to accept as I see my rheumatologist next week due to swelling and pain in hands.

Mind you...I am no doctor! I speak to you as another 82 year old and am going to share my rheumy's thoughts. I was finally diagnosed with GCA in 2019. Presently I am on 3 mg daily plus Actemra weekly painless injections.
I never got down to single digits until this year and that was at a prescribed reduction rate of .5mg per month. I do think most of the body 'miseries' are already done to my body after high doses like 80,60,40,15-----for all this time.
We are all unique I know~~so I hope your taper goes well, but personally I wouldn't care if I remained on a low dosage. I have a friend in NH who has been on 1mg for 23 year, feels fine, but cannot go without it. There is a well know rheumatologist in England, Dr. Dasgupta, who believes in keeping patients on a 2-3 mg dosage. Of course, -0- is best but I've always felt my quality of life meant more, especially soon to be 83.
I wonder what Mayo's opinion is about long term maintenance dosage? My best to you~💞