Newbie question on prednisolone short course

[Humphreydonk]

I'm new here. Just started treatment- 5 days into my prednisolone - 25 mg for one week , then Dr. recommends 20 mg for 2 weeks and then 15 mg before reassessment.

It has really helped.

I have had rheumatoid arthritis for 20 years ( am now 65) and have managed it pretty well but in October I had a massive downturn and they think I also have polymyalgia. Complex !

I have intermittent neutropenia and this too is a concern especially as I want to have the Covid vaccine asap.

Is it likely that I will be able to improve enough to come off prenisolone after 4 weeks ?

[DorsetLady PMRGCAuk volunteer]

"Is it likely that I will be able to improve enough to come off prenisolone after 4 weeks ?"- not if its PMR, no.

PMR is self limiting, but that can be anywhere between 2-6 years..... so, sorry you're in for the long haul.

[Humphreydonk in reply to DorsetLady]

Many thanks for your help

[jimcarlow75 in reply to DorsetLady]

Highly unlikely first lit took me eight years. You never know thilough

[PMRpro Ambassador]

No - PMR is a chronic condition and the media duration of pred management is just under 6 years. Only about 1 in 5 are off pred in a year and they remain at a higher risk for relapse than others. One in 3 are off pred in under two years. So no, the likelihood of being off pred in 4 weeks is negligible I'm afraid.

I think someone else on the forum has intermittent neutropenia ...

[Humphreydonk in reply to PMRpro]

Many thanks for your help.

[TheMoaningViolet]

I know what you are going through. When I was offered Prednisolone by my GP who diagnosed PMR on the basis of symptoms and limited blood tests (as it happens she was right), she gave me a prescription for one week of 15mg daily Prednisolone, no explanation as to how long it may last. At least you are here, where so much knowledge and experience is available. I wish you all best. Vx

[SheffieldJane]

You sound like a good candidate for Actemra/Tocilizumab, have your doctors discussed it with you at all ?If you are eligible, it may well shorten your time on Prednisalone, and enable you to manage on a lower dose. You are more likely to benefit from Pred if you taper down slowly once your symptoms have settled.

It must have been hard to get a diagnosis of PMR with RA because of the similarities between the symptoms of the diseases.If I understand correctly Actemra is a drug for RA that is also likely to help your PMR. Forgive me if I am wrong but I think it is worth enquiring.

[PMRpro Ambassador in reply to SheffieldJane]

It is used in RA but there are different underlying causes for RA inflammation and it, as in GCA, works on IL-6. If that happens to be the cause of the inflammation it works in RA but there is a wide range of biologics which all have slightly different mechanisms of effect.

[SnazzyD]

Hello, do you mean cyclical neutropaenia? If so, I have that; my neutrophils fall over every three weeks. Pred actually causes a rise in neutrophils though they are not as effective as when not on Pred. On high doses of Pred I was achieving dizzying heights of 4!