Methylprednisolone vs prednisone

[Isabel2]

Does anyone have experience with the IM methylprednisolone vs the daily prednisone in managing symptoms. My doctor had suggested considering this but I really need more information.

Thanks

[Green_girl]

I had all my Pred via jabs in my glutes (backside). for first few weeks I was injected weekly with a biggish dose and then it was spaced out more and more - in the end I was having them about every four to six weeks, and the steriod reduced over time too (still never more than a 10% drop, as with tablets). Had to go to rheumy nurse at hospital for the jabs - is this what you are being offered or something different? If it's something different then what follows won't help - sorry!

I haven't, so far, met anyone else being offered this option. I had it, as Pred tablets going via the stomach wall gave me very dangerous depression.

I did eventually still get quite badly depressed (but that's PMR for you....), but had no weight fluctuations and no moon face or sleep issues - but it did worsen my osteoporosis, so ended up on Methotrexate as well, to try to decrease the steroid quickly. When the jabs wore off each time, there were a few days of discomfort, but nothing really bad.

I had a brilliant Rheumy consultant and we worked out between us what I needed. Overall I had no more steroid that I would have had with tablets, but it was just administered differently. I would say that I found it a better way of delivering steroid, but I understand it doesn't suit everyone - and you can't regulate the dose yourself. It really does mean you have to talk seriously with your medic to see what's best for you.

Hope this has been of some help - and hope you ultimately have your Pred delivered in a way to suit you! Good luck.

[tangocharlie]

Yes I'm currently on a trial, roughly following the Daspgupta plan. It works so much better for me than oral Pred and fewer side effects (don't have weight gain or as many hunger pangs). All the fatigue and brain-fog has lifted, feet legs and ankles aren't as swollen and I have much more energy and vitality.

I had the first one last March 2019 - fantastic response, 2nd in July - again fantastic response. Then had to wait until October by when things dipped. I felt I wasn't having them frequently enough and have now persuaded my rheumy to give me them every 4 weeks, to be monitored and reviewed.

I think I'm probably the first person in Leeds to have this as I had to really push for it and they had to have a case conference including Dr Mackie and Dr Pease (big names in the PMR and GCA world). The Dasgupta plan is something like 120mg every 4 weeks for the first 3 months, then going down by 20g per month but not increasing the interval. My rheumy wants to decrease faster than that and I'm protesting we should stick to what we are told works!

In Dec I had a significant increase in pain and stiffness and ESR and CRP shooting up, at one point it was suspected I had GCA but luckily it was ruled out, which I put down to not having the injections often enough and inflammation getting a hold again. Although amazing, the recent response has not been quite as good as last year and not yet bringing the inflammatory markers down, so we'll see what happens.

So I'd say it's well worth a try to see if it suits you.

[tangocharlie in reply to tangocharlie]

PMRPro I can't find the link to the Dasgupta guidelines - please can you help me?

[PMRpro Ambassador in reply to tangocharlie]

The abstract for the paper is here:

ncbi.nlm.nih.gov/pubmed/956...

If you follow the DOI: link at the bottom of the test it takes you here:

academic.oup.com/rheumatolo...

where you can access a pdf of the full paper.

[tangocharlie in reply to PMRpro]

Thank you x

[Isabel2 in reply to tangocharlie]

Thank you so much everyone.. I will definitely discuss this with my rheumy