Initial trial of delayed-release prednisalone on PMR

[Pipistrelle]

I thought group members might find this interesting. acrabstracts.org/abstract/a.... The findings are being presented at a medical conference this week. The small initial trial indicates delayed release prednisalone works noticeably better for PMR and lowers pain... and may well enable lower treatment doses of preds. They are hoping to do further trials.

[PMRpro Ambassador]

Hallelujah!!!! Quite correct - says she on a sample of one! But I think it is wonderful!

[Hindags in reply to PMRpro]

PMRpro make that a same if 2.

I'd love to hear from others here who have tried the switch from day to might time dosing a and their experiences pro and con.

[Pipistrelle]

I asked all around about this to see if it was available when I first read about it a few years back, when in full throes of PMR -- but no. Glad it is now being properly trialled and discussed at professional conferences (and that you've clearly benefited!). It just made sense to me and would make such a difference, I would think, to getting a decent sleep and lessening morning stiffness and pain.

[PMRpro Ambassador in reply to Pipistrelle]

It has been available in Germany and other European areas for well over 5 years - I have been on it for that long and it was in common use before that.

[SheffieldJane]

That's interesting Pipistrelle. Thanks for posting it. A bit more bespoke too.

[katie-w53]

What is the difference between "delayed release" and "enteric coated" pred? I understand that the enteric coated takes about 5 hours to release, and is used at night / before bed by some people on this forum. It's also much cheaper than the "delayed release" version.

I am toying with the idea of taking it in the evening myself, but my GP thinks I am more likely to have digestive issues as it will hang around longer in the digestive tract overnight (I guess he means because the digestive system moves more slowly at night).

Does anyone have any views on that, and also whether it is more likely to cause sleep problems if taken in the evening?

Thanks

Kathryn

[PMRpro Ambassador in reply to katie-w53]

Delayed release means it has a coating which, under the right conditions in the stomach, breaks down suddenly after 4 hours, depositing the entire dose at once in the stomach, just the same as taking plain white pred but 4 hours later. Enteric coated or gastroresistant pred has an acid-resistant coating so it passes through the stomach and is then broken down and absorbed lower down the gut, so reducing the irritant effect on the stomach.

The only way to know is to try - you may. Or you may not.

[katie-w53 in reply to PMRpro]

Thanks for that explanation, very helpful as always.

[Zebedee44]

Hi Pipistrelle, i haven't been able to access the article you linked to but I have been taking the enteric coated at bedtime for some time now and finding it gives me relief from pain throughout the day, although at 7mg I am now sore in the late evenings. I am currently experimenting with 5mg at bedtime and 2 uncoated in the morning, and hope to start a taper to 4.5 mg at bedtime in a week or two.

I now find posts about needing to get up more then once during the night to have a pee, which I hadn't connected to the nighttime dose. But I will persevere, because I feel good in the morning. If it's not one thing it's another with this PMR!!!🤷‍♀️