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The impact of Prednisone on A1C

Polymyalgia Rheumatica (PMR) | Last Active: Apr 25, 2023 | Replies (15)

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@ella0515

Thank you for your response. When you mentioned “biological” helping you in tapering off from prednisone, can you tell me what these biologics are ? Thank you. I’ve been on prednisone for 2 years currently on 7.5 mg. But my weight and puffy face have almost “ disfigured “ me and my self esteem. Any info would be greatly appreciated.

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Replies to "Thank you for your response. When you mentioned “biological” helping you in tapering off from prednisone,..."

I personally take a biologic called Actemra (tocilizumab).

My rheumatologist had to get authorization to prescribe it to me. Actemra isn't FDA approved for PMR. However, Actemra is FDA approved for GCA so my rheumatologist believed that Actemra should work for PMR too.

There is ongoing research being done. This link gets too technical for me but it is still interesting.
https://www.cureus.com/articles/99487-is-tocilizumab-effective-and-safe-in-polymyalgia-rheumatica-and-giant-cell-arteritis-with-polymyalgia-rheumatica#!/
I hope this helps.

There is another biologic medication that targets the same IL-6 inflammation pathway. This biologic was recently approved by the FDA for the treatment of PMR.
https://investor.regeneron.com/news-releases/news-release-details/kevzarar-sarilumab-approved-fda-first-and-only-biologic#:~:text=(NASDAQ%3A%20REGN)%20and%20Sanofi,corticosteroids%20or%20who%20cannot%20tolerate
Neither of these two biologics work perfectly. However, I think a more targeted approach to the treatment of PMR/GCA is a step in the right direction.

Actemra (tocilizumab) is sometimes abbreviated TCZ --- it works for me. I was able to taper off prednisone in 12 months after taking prednisone for 12 years. I don't have anywhere near the problems I had when I was taking prednisone for PMR. That is just my experience ... when my rheumatologist suggested Actemra to me, there were no guarantees it would work.

Another problem is these biologics are very expensive. My rheumatologist made the case that all other less expensive alternatives didn't work for me. He didn't think taking prednisone for the rest of my life was a viable option.

Part of my difficulty was multiple autoimmune problems. My rheumatologist has acknowledged it would be impossible to adequately treat everything the was happening.