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Tapering off PMR after five years using Prednisone and Methotrexate
I have been with PMR for 5 years and we started tapering off the medications (Prednisone and Methotrexate) but it is not working. It looks like I have a flare up again. Any suggestions are well received.
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How fast. Is taper? What % drop, and hold at that for how long?
Supplement with Tylenol for arthritis, 2 in morning, and 2 at bedtime if need be.
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1 ReactionHave you tried Kevzara? It can take several months to take effect, but it works very well for some people. I take a similar drug, Actemra, and I'm completely off prednisone and don't have any symptoms of PMR or GCA.
PS: ditto, ask Dr Abt Kevzara. I’ve been successful with it.
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1 ReactionFrom 5 milligrams every day to 5 milligrams every other day.
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1 ReactionAfter 5 years of Prednisone with relapses there is more than enough justification to try a biologic. Kevzara is the logical choice for PMR alone. If GCA or vasculitis is involved, maybe Actemra is now the best alternative to Prednisone. There's even more justification to try a biologic if methotrexate doesn't work. Regardless of what you try next ... you will still need to continue prednisone until an alternative is found. Research and medical guidelines support a gradual tapering approach of Prednisone to allow the body's adrenal glands to recover, especially after long-term use.
Other than a slow and gradual taper of Prednisone, there is no evidence based taper plan that works the best for everyone.
Did your Dr give you any advice?
Maybe methotrexate is not the correct biologic for you.
Maybe another like Kevzara might work.
Are you pain free?
How long have you been at 5 mg?
My PERSONAL experience is 2 weeks pain free before taper……
What’s the largest dosage of Methotrexate you e taken?