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Polymyalgia Rheumatica treatment options

Posted by Marshahj @marshahj, Jan 5, 2012

Has anyone experienced complete management of symptoms at onset of disease with Prednisone and then experienced a major setback while decreasing the dosage? If so, what treatment plan was used? Also, has anyone had any success with any other prescribed medicines in the treatment of the disease? My husband was diagnosed three months ago and with first major dose of Predison (60mg) he improved 100% with symptoms totally subsiding. The symptoms returned when the doseage was reduced to 20mg. He is currently taking 40 mg but his symptoms have never completely subsided again. His rheumatologist started him three weeks ago on Methotrexate as well in hope to use this med as treatment and take him off the Predisone. Thus far the treatment plan does not appear to be working. My husband is also experiencing most side effects from the use of long term Predisone which is also a reason for considering an alternative treatment.

Thanks and appreciate any information provided.

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

marymckeith | @marymckeith | Aug 29, 2023

Okay, just about ready to give up. On 17.5 Prednisone down from 20 started in April. Prednisone has brought on diabetic symptoms which has made me exhausted. I wanted to try Prednisone and for two months it was absolutely wonderful. I tapered to 15 and had to start again at 20. Maybe I was better off when I got cortisone shots in back, shoulder or hands whenever I needed them—every 4-6 months. Sorry I started Prednisone but I needed relief and wanted to try it. How can I ever get off it? Too many side effects. I have a good doctor but can't get an appointment with a rheumatologist .

REPLY
bix53 | @bix53 | Aug 30, 2023
In reply to @joanna626 "I started taking 15 mg of predisone and within a week I was 80 percent better...." + (show)
@joanna626

I started taking 15 mg of predisone and within a week I was 80 percent better. I could not get out of bed so it was like magic in 7 days. I have always exercised and was down for 2 days and made myself get moving again (cycling) and it helps enormously with pain. I am a little stiff in AM but after a 2 hour ride on a road bike at night I am almost back to the old me except the creepy prednisone feel. Everyone is different but ---- moving is crucial.

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Also showed immediate improvement; 80% immediate improvement sounds right. Now in month 7 (currently at 10mg prednisone) and riding with some frequency, about 100 miles per week. Still stiff in am, feel better after ride, but pain still present in later afternoon and evenings. Imagine that lack of exercise would make this considerably worse.

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1 reply
bix53 | @bix53 | Aug 30, 2023

Understand declining my prednisone (started at 20 in Feb, now at 10) prescription will last about 12 months. Will decline by ~1 mg per month. Was told that this was optimal long-term treatment. Only comment here is that 60mg sounds remarkably high and would remove most inflammation immediately. Good luck to your husband.

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Mentor
John, Volunteer Mentor | @johnbishop | Aug 30, 2023
In reply to @bix53 "Also showed immediate improvement; 80% immediate improvement sounds right. Now in month 7 (currently at 10mg..." + (show)
@bix53

Also showed immediate improvement; 80% immediate improvement sounds right. Now in month 7 (currently at 10mg prednisone) and riding with some frequency, about 100 miles per week. Still stiff in am, feel better after ride, but pain still present in later afternoon and evenings. Imagine that lack of exercise would make this considerably worse.

Jump to this post

Hello @bix53, I see that you have already connected with @joanna626 and I would like to add my welcome to Connect. It sounds like you are doing well with your prednisone tapering schedule. I also think exercise is important but if I did too much, I would pay for it later that day or the next. It was kind of a balancing act with exercise for me during both of my PMR occurrences.

There is another discussion you might also find helpful:
--- PMR Dosages and Managing Symptoms: https://connect.mayoclinic.org/discussion/pmr-dosages/.

What was your starting dose of prednisone after being diagnosed with PMR?

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