I am new to this site, about 9 m ago I had finally recovered from about 18 months of PMR.

[Dawnint]

It now seems that it is back with a bang. Just had blood test to try to check.

My question is would it have been better to stay on a small dose of prednisolone?

[powerwalk]

Probably yes. 18 months would be very lucky to be cured. Though im sure it may happen to the lucky few. Did you feel good when you finished the pred or did your doctor take you off it?

[jinasc]

PMR comes and goes when it wants, it has a mind of its own - so it is not cured, it goes into remission and then decided, in your case and a few others I know, to come back again. Taking any drug when you do not need it is not a good idea.

[Soraya_PMR]

It probably hadn’t ‘gone’ after 18 months. I’d not advocate staying on low dose pred ‘just in case’ but you possibly needed to taper slower and therefore might have still been on a low dose now, IYSWIM?

I don’t think PMR follows a linear decline, more cyclical maybe, or wavelike? Therefore this MIGHT be a ‘natural’ rise in activity, or due to increased activity or stress or other illness (cold/infection).

Hopefully you won’t have to go back to the beginning of pred again, but might be able to reduce reasonably swiftly to a lower dose.

[PMRpro Ambassador]

About 1 in 5 patients are able to get off pred for PMR in under 2 years - but it has always been said that patients with short-lived episodes of PMR are more likely to relapse. For it to have taken 9 months for the symptoms to reappear it probably does mean it had gone into remission - if it hadn't then the symptoms would probably have recurred after a couple of months or so. Patients who take a long-ish time to reduce because they go more slowly may well spring over such short-lived remissions.

You were able to get off pred altogether, you have had 9 months drug-free. That is a good thing. But don't assume you could start at a low dose - most people who have second episodes find they are nothing like the first. But most of them are a lot more relaxed about the use of pred second time around.

[HeronNS]

When I started pred my doctor actually told me she had patients who kept a supply of 1 mg tablets on hand after they were finished with pred and PMR just in case they needed it from time to time. I think the idea was it was better to head problems off at the pass rather than to allow them to build up. And eventually they would no longer need even the occasional dose. I haven't got to that stage yet!