Hi @emer, I see that you have already connected with another new member @curtvapor. I would like to welcome you both to Connect. There are a couple of other discussions on the use of Actemra for treating PMR that you might find helpful.
--- Actemra (Tocilizumab) to treat PMR??: https://connect.mayoclinic.org/discussion/actemra-tocilizumab-to-treat-pmr/
--- How hard is it to get on Actemra (Tocilizumab) with PMR?: https://connect.mayoclinic.org/discussion/how-hard-is-it-to-get-on-actemra-tocilizumab-with-pmr/.

@emer, You mentioned you have been reducing prednisone slowly. Each of us are different when it comes to tapering off of prednisone. Here's some information I found on your question about ESR levels and prednisone.

"Monitoring CRP (or ESR) is often helpful when assessing a patient’s response to prednisone; levels generally decrease within a few days of treatment initiation and normalise within two to four weeks.8, 13 However, levels of inflammatory markers may not always correlate with the patient's symptomatic response. In addition, some patients may have elevated baseline levels; especially patients with obesity, where levels of inflammatory markers may never fall within the normal range which can make their use for monitoring difficult. A pre-diagnosis baseline CRP (or ESR) measurement is useful to compare in this situation if available. "
--- Polymyalgia rheumatica (PMR) – look before you leap: https://bpac.org.nz/2023/pmr.aspx

Are you able to discuss alternative treatments like Actemra suggested by @curtvapor with your rheumatologist to see if that might be an option for you?