MPR flare-up or Aclasta reaction?

[DeWet]

Went off prednisone early in July 2022. Was fine till 10 days ago. Started with pain in my legs and with 5 days spread through my whole body - same as I had when I was diagnosed with PMR in March 2020. Because of a low bone density scan the specialist physician recommended Aclasta infusion that was done the end of July 2022. I was fine till 10 days ago.

Is this a PMR flare-up? What role if any did/does Aclasta play in this?

[PMRpro Ambassador]

It may or may not have played a role - but the time scale is really typical of someone stopping pred when the underlying autoimmune cause of their PMR symptoms is still ongoing though at a really low level. There have been people who were taking 1mg pred every third day and were fine but when they thought that was it, back came the symptoms within a couple of months! As long as the inflammation is being cleared out regularly you fell fine - but zero pred allows the inflammation to build up like a dripping tap fills a bucket sooner or later and it overflows.

[DeWet in reply to PMRpro]

Thank you indeed "Ambassador". Your comments makes perfect sense. I restarted the use of Prednisone (15mg) this morning and am already feel somewhat better. I shall "drain the bucket" and after a week start tapering down.

[piglette]

Problems do seem to come along particularly in the first three months after stopping the steroids. What I would do first is try 5mg for a few days and see if that helps.

[DeWet in reply to piglette]

Thanks piglet. Valuable advice.