Polymyalgia rheumatica: Any thoughts on my taper plan?

Posted by casinokid1121 @casinokid1121, Jul 13 4:30pm

I am currently on 2.5 milligrams of prednisone. I plan on tapering 1/4 milligram every 4-6 weeks to hopefully get down to zero. Any thoughts or suggestions would be appreciated. I had a starting dose of 30 milligrams 18 months ago. No significant flare ups so far, thank god.

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Profile picture for checlark @checlark

Our stories are very similar. Along with PMR I also have GCA. I got down to 3mg, feeling great and all my markers were normal. I went to 2mg and had no PMR symptoms but the GCA symptoms came on fast. Tender scalp, headache, runny nose, neck pain, etc. Went up to 3mg and it was a little better. Went to 5mg and now feel normal again. Hopefully I can taper back down to 3mg and ride it out from there.

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I'm glad you feel better at 5 mg. I felt like I had a lot of doses during my taper where I felt better - 40, 20, 12.5, 7, 5, 3, and 2. 5 wasn't too bad, and 3 was better, at least for me.

I just googled what percentage of people with GCA have flares, and it said approximately 34 - 74.5, depending on various factors.

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Profile picture for fudge08 @fudge08

Thank you! Glad to hear about your progress and successful treatment.

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Wish you the best also my friend!!!

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Profile picture for jeff97 @jeff97

I have PMR and GCA. Before treatment I remember lying in bed at night trying to decide if it was worth the pain to turn over to get into a more comfortable position. I also had a lot of trouble putting on socks and also shirts and jackets due to shoulder pain. Driving was difficult too, because of my stiff neck. Since I started treatment (prednisone plus Actemra a little later), I haven't had any pain or stiffness at all.

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Glad to hear your treatment is working well for you. I never had to be on Actemra though. Any side effects? Wish you well.

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Profile picture for reets70 @reets70

My initial CRP two years ago was 79! I was in terrific pain and did not know why. My rheumatologist immediately ordered methylprednisolone and within 12 hours, I was walking pain free! Pain and stiffness returned, but easier to control with medication. This diagnosis is not for sissies!

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Absolutely correct.

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When you tapered from 3mg to 2mg, did you go directly from 3mg to 2mg? I went from 3mg to 2.5mg to 2 1/4 and then I'll go down to 2. I will go down a 1/4 every 6 weeks. Fingers crossed it works.

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Profile picture for casinokid1121 @casinokid1121

Glad to hear your treatment is working well for you. I never had to be on Actemra though. Any side effects? Wish you well.

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No, I don't have any side effects from the Actemra. Although there are some risks to it, I really like it a lot. It looks like it will save me from being on prednisone for another year or more.

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Profile picture for jeff97 @jeff97

I'm glad you feel better at 5 mg. I felt like I had a lot of doses during my taper where I felt better - 40, 20, 12.5, 7, 5, 3, and 2. 5 wasn't too bad, and 3 was better, at least for me.

I just googled what percentage of people with GCA have flares, and it said approximately 34 - 74.5, depending on various factors.

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Yeah I hope I can get back down to 3 and that it will keep my PMR and GCA at bay. I could live with that. Good luck.

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Profile picture for fudge08 @fudge08

Thank you for those insights. My doctor is going to retest the sed rate and CRP on Friday., and probably run some more tests. Between your test times had your symptoms gotten worse, better or stayed the same? I would suspect if your inflammatory labs went up that your symptoms were persisting.
I am slightly better after this week’s PT, she did the dry needling in my piriformis muscles but still very sore in glutes. Still far from where I want to be. I am taking Advil daily for now.

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I slowly deteriorated until I saw the rheumatologist, about 6 months after the referral was made. I stayed on a low inflammation diet (ate so many blueberries that my urine turned pink), went to PT and had a PT who was perfect- familiar with my local Ys and worked with me to jave a complementary gym program going. But I was rather severely affected by late summer....PT told me "At XYZ( my favorite Y branch, and is also a medical fitness facility with an amazing pool), the parking is not close. There will be days when all you can do is get there, walk in the building with your bag, and turn around, walk back, drive home. I'm going to count those days as a Win." And he was right. Some days I could barely walk into PT with my cane.
I also took Turmeric and Tylenol. It was really rough.

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Profile picture for casinokid1121 @casinokid1121

When you tapered from 3mg to 2mg, did you go directly from 3mg to 2mg? I went from 3mg to 2.5mg to 2 1/4 and then I'll go down to 2. I will go down a 1/4 every 6 weeks. Fingers crossed it works.

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My experience is similar to yours. I started it at 4 mg of prednisone for my PMR and I stayed on that for several months before I started to taper. I tapered from 4 to 3 and I was fine. I stayed on that for about a month and then I went down to two and that’s when I experienced some pain. I went back up to three and stayed there for another week or two and then I went from 3 to 2 1/2 and I have a little bit of stiffness, but it’s tolerable.
I will stay at 2 1/2 for about three weeks and then try to go back down to 2 and see how I do.
Everybody is different and everyone reacts differently to the taper.
I’m just praying that I’ll be able to get off of prednisone soon.

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Profile picture for aussiedogmom @aussiedogmom

I slowly deteriorated until I saw the rheumatologist, about 6 months after the referral was made. I stayed on a low inflammation diet (ate so many blueberries that my urine turned pink), went to PT and had a PT who was perfect- familiar with my local Ys and worked with me to jave a complementary gym program going. But I was rather severely affected by late summer....PT told me "At XYZ( my favorite Y branch, and is also a medical fitness facility with an amazing pool), the parking is not close. There will be days when all you can do is get there, walk in the building with your bag, and turn around, walk back, drive home. I'm going to count those days as a Win." And he was right. Some days I could barely walk into PT with my cane.
I also took Turmeric and Tylenol. It was really rough.

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That sounds really bad, and a reminder that it takes a long time to see rheumatologist, and when you are in pain it’s like forever. My GP follow up is this afternoon and I am anxious for the appointment. I hope my inflammatory labs are still normal. I know that I could still have PMR, but I will hope they are still low.
My PT does not think it is PMR and says that while I am still very sore and stiff, she sees progress. In the meantime it cannot happen fast enough. All my soreness and stiffness are in my piriformis, glutes and hamstrings but walking is painful. Sleeping better at night. The PT exercises make me sore, of course, and my rotator cuff is firing up. I realized I have a right shoulder problem last year when I started playing pickleball. When something like this hits you all at once, it is very scary, as many have said!

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