asthma and pmr : does anyone else have both these... - PMRGCAuk

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asthma and pmr

Yellow-dog profile image
30 Replies

does anyone else have both these conditions? And if so do you find that they seem to get worse , or better, together? I am wondering if they are linked, since they are both inflammatory responses.

I am struggling with tapering, especially as I think the steroids are helping with asthma.

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Yellow-dog profile image
Yellow-dog
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PMRpro profile image
PMRproAmbassador

The steroids will definitely be helping with the asthma - have you discussed that with your GP in relation to the tapering?

Yellow-dog profile image
Yellow-dog in reply to PMRpro

my rheumatologist unhelpfully decided she didn’t need to see me again , last appointment was in March. So apart from this forum I haven’t got anyone to ask for advice. The rheumatologist and gp are one and the same person.

I did have an appointment with the respiratory consultant recently so asked his advice, although Pmr isn’t his area of expertise. It’s complicated having two fairly serious problems at the same time.

PMRpro profile image
PMRproAmbassador in reply to Yellow-dog

"The rheumatologist and gp are one and the same person."

Surely in that case she can't sign you off if you are still on pred. What a strange system! Where on earth in the UK does that happen - primary and secondary care are separate.

Yellow-dog profile image
Yellow-dog in reply to PMRpro

I agree, strange system

PMRpro profile image
PMRproAmbassador in reply to Yellow-dog

Seriously - what hospital trust/CCG has that sort of arrangement?

piglette profile image
piglette in reply to Yellow-dog

Surely a rheumatologist is secondary care working for the NHS and you GP is primary care not working for the NHS but a GP practise??

Yellow-dog profile image
Yellow-dog in reply to piglette

so you would think

piglette profile image
piglette in reply to Yellow-dog

I don’t understand. Where do you see the rheumatologist at a hospital or a GP’s surgery?

Yellow-dog profile image
Yellow-dog in reply to piglette

telephone appointment

PMRpro profile image
PMRproAmbassador in reply to Yellow-dog

No - that isn't what we mean. You said your rheumy is also your GP?

piglette profile image
piglette in reply to Yellow-dog

How did you contact them originally at a GP surgery or a hospital?

Suffererc profile image
Suffererc in reply to Yellow-dog

sorry I really don’t understand how your GP can be the Rheumatologist as well and it done by telephone . What is it BOGOF.

123mossie profile image
123mossie

the asthma inflammation is different to the pmr inflammation though both respond to steroids. The asthma should be improved on the daily dose of pmr pred - you don’t say how much you’re taking though. Assuming you are on inhaled steroids too that will be adding a bit more to your total dose.To answer your question they are not linked but share the same mode of treatment.

krillemy profile image
krillemy

Hi, I have both. Asthma started not to long before PMR. There is not allergy or explanation to it. I do not need inhalation when on +15 mg pred. If messing around in the garden on a dry day or if I am in air-condition (car) for too long I do take some.

Uke1 profile image
Uke1

Hi. I have had asthma all my life, on and off and, yes, you would think the pred would help the asthma but, for me, the “chestiness “ and shortness of breath have got worse over the two years I have had PMR. I am now tapering from 2.5mg to 2mg and no change with the asthma symptoms. I have recently been diagnosed with a “thin-walled “ cavity in my upper left lung which I’ve had various scans and tests on although they can’t do a biopsy as it’s right behind the clavicle. Hopefully it’s nothing serious and it’s being kept an eye on but I do wonder whether that has anything to do with my symptoms.

BPlady profile image
BPlady in reply to Uke1

Hi, I was interested in your comment because I have never had wheezing until I started Pred, I have been treated for PMR since 2019 with just a brief few months this year when I managed to get the dose to zero with tapering and my wheezing disappeared. Unfortunately, PMR flared again, and now I’m back on 15 mgs and wheezing! It’s bizarre; I thought people were prescribed steroids for asthma but it actually seems to cause it for me.

Yellow-dog profile image
Yellow-dog in reply to BPlady

that’s interesting, I wonder if you are allergic to something else in the medication, something in the coating maybe? Just a thought,

BPlady profile image
BPlady in reply to Yellow-dog

Yes, and thank you for that; I hadn’t thought about that.x

Rostom profile image
Rostom

Hi Yellow-dog. Yes, a life-long asthmatic here (taking a steroid inhaler, 'Symbicort' which has been marvellous in helping control the inflammation of asthma. This drug is not a 'reliever', which is taken when having an acute bout of breathless. If on the former, one should need much less of the latter, if that makes sense!).

I am almost eleven months into my PMR journey and just trying to reduce from 8 mg to 7 mg as of yesterday but have felt the PMR stiffness and pains return in a major way, so I am having to scale up a bit but will try again another time - quite dispiriting really, although this wonderful forum has helped me understand that reduction of prednisolone is not a race.

I don't think that I have noticed a correlation between asthma and PMR symptoms reducing/multiplying (although there obviously looks as if there should be one) when reducing the prednisolone. My asthma is very stable with Symbicort and only flares with a cold or chest infection etc. I will just plod on plodding on but am very thankful that prednisolone even with all of its disadvantages, is available to help with the PMR pain and the asthma, too.

I used take prednisolone for a week or two when diagnosed with a chest infection but of course, that's very different to daily dosing long-term.

As mentioned I began a taper of my prednisolone yesterday and am in PMR trouble (very painful overnight, slightly better when up and about) almost immediately, so can't be ready for a 1 mg drop yet. I know I should have dropped less than 1 mg but I am on enteric-coated prednisolone which can't be cut: I will have to ask for some 'ordinary 1 mg prednisolone which I can cut.

I hope that you are able to distinguish which illness is which but my short answer is no, no correlation between the two illnesses so far.

Wishing you better.

Yellow-dog profile image
Yellow-dog in reply to Rostom

thankyou for your reply. I have recently started taking an inhaler called trimbow, too early to say if it’s better than the previous fostair nexhaler. Like you I have had high doses of steroids, short term , for asthma flare ups.

Regarding tapering, you can get 2.5 mg tablets, which would enable you to make up a 7.5 mg dose. Alternatively you could try alternating 7 mg with 8 mg.

Still unsure if asthma and pmr are connected,

Good luck with tapering

Uke1 profile image
Uke1 in reply to Yellow-dog

Interesting, I have recently changed to Fostair after years of Seretide. Fostair worked well initially but now my breathing is tight again,

Twinkling1 profile image
Twinkling1 in reply to Rostom

I don’t cut the prednisolone, I take 5mg one day and 6mg the next for eg this is classed as half a doze. This is at 6 week intervals after which it will be 5 everyday for 6 weeks and then on my next taper I will take 5 one day and 4 the next. The distance between tapering does help it allows my body to adjust.😊

also a life long asthmatic and on the same inhaler.

PMRpro profile image
PMRproAmbassador in reply to Rostom

e/c comes in 5, 2.5 and 1mg doses - you can do 1/2mg drops down to 2mg without cutting by combining 2.5mg tabs with 5s and then 1s to get the dose

HalleysComet profile image
HalleysComet

I stopped all my asthma inhalers when i was on 15mg pred. As I have tapered to 3.5 now I am wheezing again. I have started taking my duo-resp inhaler again. Wheezing has diminished.

Rostom profile image
Rostom

Thanks to Twinkling1 and PMRpro re. tapering information.

I didn't realise that there was a 2.5 enteric coated pred available. These could be very helpful, although I have just begun the DSNS regime. If this doesn't suit me I will ask for the 2.5 mgs and taper very slowly using 0 .5 drops.

As with most poster here, I feel quite alone (GPs are really busy, diagnosed in hospital and not seen a Rheumatologist and don't expect to!) and glean knowledge from some lovely people who are prepared to give their time to us.

Thank you for your help.

PMRpro profile image
PMRproAmbassador in reply to Rostom

The DSNS taper was partly developed for people on e/c pred - at the time there were no 1mg tablets and there were some people who couldn't tolerate any plain pred. If you repeat each step of the DSNS a few times it will work even with 2.5mg drops

sewinggranny profile image
sewinggranny

I have had asthma for many years, using Pulmicort and Bricanyl inhalers. Diagnosed with PMR in June this year. I am doing a very slow taper; I have found that works better for me. I started on 20mg prednisolone, am now on 15mg will reduce by 1mg every 3 weeks from now on. Last week I was told to increase my inhaler up to 2 puffs twice a day because I have been quite breathless. My experience is the asthma has worsened; it had been quite stable prior to the onset of PMR.

Yellow-dog profile image
Yellow-dog in reply to sewinggranny

thanks for replying, it looks as if there may be a link between asthma and pmr, for some of us at least. I hope your asthma stabilises again soon.

PMRpro profile image
PMRproAmbassador in reply to Yellow-dog

They are both autoimmune conditions - and when you have one a/i condition, you are more likely to develop another

Karenjaninaz profile image
Karenjaninaz

I have asthma but also moderate restrictive lung disease from scoliosis. The 15 mgm starting dose for PMR never improved my asthma- and I actually felt more short of breath. Respiratory muscles are also affected- weakened by steroids- according to an abstract from the Journal “Chest”. I also takes Symbicort . I notice, when I first taper, I do get more wheezy but it stabilizes in time. This is scary at first and I might need more frequent albuterol.

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