Titration down in steroids
I was on prednisone and had been since last February. I titrated down to 1mg from 17 so very gradually. I took my last one on New Year’s Day but now have pain and stiffness and feel nauseous would this be due to stopping the steroids as I titrated down very slowly
Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.
People find different things that work for them. Collectively they are all called "Steroid sparing medications." Most doctors will introduce an alternative to you if and when you have a flare when you try to lower your prednisone dose. Methotrexate and Leflunomide are two medications I tried first. They come in a pill form and they help some people get to a lower dose of Prednisone. Both of these medications are called "conventional "steroid sparing medications. There are some other conventional medications that might work.
The medication that worked for me was a "biologic" medication that I get as an IV infusion every month. It is called Actemra (tocilizumab). It is mostly for people with GCA but some people have both GCA and PMR and get it.
https://www.actemra.com/gca/considerations/gca.html#:~:text=ACTEMRA%20is%20the%20first%20prescription,ACTEMRA%20is%20not%20a%20steroid.
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Another biologic called Kevzara (sarilumab) is what some people have received for PMR. This medication is given as a weekly injection.
https://www.kevzara.com/hcp/pmr
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Both of these biologics work in similar ways. The big drawback is that they are expensive. For this reason doctors don't usually try them right away.
You can mention all of these medications to your doctor the see what they think might be appropriate for you. There is no guarantee any of them will work for everyone. This is why people need to find an alternative to Prednisone that works for them. Some people don't seem to mind staying on Prednisone.
I personally think the sooner you can get off Prednisone ... the better. Unfortunately, tapering off Prednisone can take a long time.
Thank you
An excellent video by a rheumatologist who is very well-versed in PMR
https://connect.mayoclinic.org/discussion/comprehensive-overview-of-pmr/