I’m going too fast again!

[daworm]

Been feeling better, morning stiffness everyday and some shoulder stiffness but some may be related to pre existing OA...so to see if I’m on a good taper I really read this “stuff” from Medscape on PMR...I’m going too fast, only waiting two weeks before dropping again..should stay on dose a month or two...I go down 1/2mg at a time...we will see how I feel tomorrow after shoveling snow off of porch roof today..we’re buried up here in U.P. Mich...here’s part of the paper for others or “newbies” to PMR..

A slow tapering of the prednisone, less than 1 mg/month, was associated with fewer relapses. Once prednisone is tapered to 10 mg/day, a slow taper by 1 mg every 2 months until treatment discontinuation was associated with optimal control of disease activity. [32]

Nevertheless, controversy remains regarding dose and duration of treatment. Dose depends on the patient's weight and severity of symptoms. Expect prompt relief of symptoms within 24-72 hours. Corticosteroid dose should be increased if symptoms are not well controlled within 1 week, and a diagnosis of giant cell arteritis may need to be pursued, especially if prednisone 20 mg/d does not control symptoms. In contrast to other rheumatic diseases, alternate-day administration of corticosteroids in PMR has largely been unsuccessful.

Tapering should be guided by clinical response to include decreased pain and stiffness, decreased morning stiffness, and decreased shoulder pain/limitation on clinical examination. [33, 34] Normalization of inflammatory markers is also helpful but should not be used as a guideline for decreasing or stopping treatment. Patient-reported outcomes including global pain, hip pain, morning stiffness, physical function, mental function, as well as inflammatory markers have been reported as the best measures of disease activity and response to treatment.

[DorsetLady PMRGCAuk volunteer]

We know this - pity many doctors don’t!

Slowly is the tried and tested way!