How common is PMR without flares?

[Joydeck]

I contracted PMR two years ago and have just tapered to 5 mg prednisolone. Since taking pred, I have not had a single flare. How common is that?

I have experienced PMR symptoms from too rapid a taper, and needed to back off a little. And I was stuck around 7 mg pred for an entire year.

[Hidden]

I have only had PMR/ GCA since March this year, but I haven’t had a flare.

My brother has had PMR since last year and hasn’t had a flare.

My father had it from his early 90s until he died aged 99 and didn’t have a flare.

Linds

[DorsetLady PMRGCAuk volunteer]

Hi,

“I have experienced PMR symptoms from too rapid a taper, and needed to back off a little.”

Most people would think that is a flare.

[Joydeck in reply to DorsetLady]

If many flares stem from overoptimistic tapers, my subject question becomes:

How common are PMR flares unrelated to an overoptimistic taper?

[PMRpro Ambassador in reply to Joydeck]

The medical literature admits that the most frequent cause of flares is reducing too fast or too far. I do know a few people who reduced their dose steadily, had no flares and got off pred - but most of them have been members of the forums and had DSNS tapering rammed down their throats!!!!

One imagines that the 1 in 5 patients who is able to get off pred in a year didn't have flares - though of course, was it really the PMR we talk about? Or the ones who managed the feat in 2 years?

I don't flare due to overshooting the dose I need - but I have flared a few times because of increased disease activity and once because of a dodgy batch of pred.

[DorsetLady PMRGCAuk volunteer in reply to Joydeck]

Not that many I would say - they don’t usually happen for no reason!

But as PMRpro says can be a combination of over activity and/or not enough Pred.

[Hidden]

I agree with DorsetLady. A flare, as I understand it, is a return of symptoms that require an increase in pred. That may be because you have tapered too fast or far or because the there is an increase in symptoms due to external physical or emotional stressors. I had been at 6mg for just under 12months and had to increase after several physical issues and emotional events resulted in increased symptoms (a flare). I did 3 days of 10mg and have been on 7mg since.

[Koalajane]

I had my first flare when reducing to 4mg from 4.5mg. Now on 5mg for a while

[tytto]

In almost 2 years I have not had a "flare" but I think some of the issues when tapering down too quickly are that the PMR has not gone away!