Thanks for your reply @samara66

My a.m. cortisol level was tested and found to be low. There wasn't much that could be done as long as I needed prednisone for treatment. I was encouraged to taper down to the lowest dose of prednisone as possible. The best I could do was 7 mg when familiar aches and pains would recur. I would need to go back to at least 10 mg again every time.

I took prednisone for 12 years to treat PMR so an endocrinologist wasn't very optimistic that my adrenal function would improve. Adrenal insufficiency can cause muscle aches and pains and can mimic PMR symptoms. I wouldn't say the symptoms of adrenal insufficiency were exactly the same but enough to cause confusion.

I was able to taper off prednisone when a biologic that doesn't suppress adrenal function was tried. I tapered my prednisone dose down to 3 mg and stayed at that level for about 6 months. My a.m. cortisol level improved to the extent that it was "adequate." My endocrinologist said it might be safe to stop prednisone. She said going from 3 mg to zero would be okay. My endocrinologist provided the leeway such that I could take prednisone again for any reason if I felt the need.

I did a quick taper down to zero over a couple of days and I was suddenly off prednisone. I didn't feel well for several more months but I didn't have a PMR flare.

I can't explain what happened other than the biologic controls PMR inflammation but doesn't suppress my adrenal function. I still take a biologic to treat PMR but I have been off prednisone for more than 2 years.

I have been on the biologic for more than 3 years and PMR might finally be in remission. My rheumatologist says I'm better off on the biologic and is in no rush to stop the biologic anytime soon.