I have PMR can tapering bring about GCA?

Posted by lsa22 @lsa22, 1 day ago

I am 64 year old female and an avid cyclist. I came home from a south pacific cycling/cruise trip in May. I started a prescription of terbinafine to cure a big toe fungus and within a matter of days was unable to get out of bed in the morning with sore stiff gluts, hips, shoulders, triceps. I was diagnosed with PMR - all blood work was normal even SED and CRP. At 30 mg prednisone I was pain free (split 20mg am 10mg pm. I started a tapper in July with Zyenne injections 4 in total 2 weeks apart with a tapper to 5mg (split 2.5 am 2.5 pm). I had a bad skin reaction on the 4th injection so doc changed to Kezvara this week. I feel stuck at 5mg and even wonder if now I am getting GCA. I have not had any classic GCA symptoms like I did with PMR.
At 5mg prednisone
-my shoulders do hurt in the morning but get better as I stretch and do strength exercises.
-my hips get stiff is I sit too long.
-feeling of pressure on top and back of head
-pain in back of neck
-maybe a vision change on left eye, or I am just going a bit crazy.

I am so exhausted from this condition and in denial and now could I really be getting GCA? How do you know for sure?

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

jeff97 | @jeff97 | 1 day ago

I have GCA and PMR, so I'm familiar with both conditions. It sounds like your PMR is not completely controlled by 5 mg prednisone. Google says Kevzara can take up to 12 weeks to take effect. You could ask your doctor to raise your prednisone dose a little to get you through until the Kevzara starts to work.

Regarding your vision, you could see an ophthalmologist and tell them you have PMR and are concerned about GCA, and they can look for any early signs of GCA. Also, prednisone can affect your vision. It can cause glaucoma and can accelerate the development of cataracts. So it's good to see an ophthalmologist regularly while you're taking prednisone.

ropnrose | @ropnrose | 17 hours ago

There are tools that could diagnosed GCA. An ultrasound or temporal artery biopsy. As @jeff97 suggested, you might want to see an opthalmologist. I acquired PMR and suspected GCA in July 2024 and I had a bi-lateral temporal biopsy. The result was inconclusive. No unusual for that to occur. Since I was showing classic symptoms, I was treated with 60 mg. of Prednisone for 6 weeks. Then, I began tapering. My headaches would be across my eyebrows, to my temples, over my ears and behind my ears. The GCA didn't really affect my vision. What did affect my vision was the prolonged use of high doses of Prednisone, which also, increased my blood sugar. Not unusual for it to be over 200. My vision is worse now, than pre-PMR/GCA.

Now, I am down to 3 mg. of Prednisone, with the help of Actemra infusions. I still aches in my knees and hips, but it's manageable. Good luck!