I was diagnosed with PMR in May 2020. I tapered my prednisone down to 0 in Oct 2021. My inflammation markers have remained low so my rheumatologist has given me a prescription of 5 mg, if needed, for self medicating, I use Tylenol Arthritis for any symptoms that could be misdiagnosed as PMR.
My question: Since it’s been over a year off prednisone what are the chance of a PMR flare up?
Sorry - but that is a how long is a piece of string question! The original episode seems to be well in remission after a year - up to 6 or 7 months a very low disease activity can result in inflammation and symptoms building up. But it is possible to relapse - and it could be next month, next year, next decade ...
I’ve been wondering if I’m in remission since my CRP has been normal now for over a year. (PMR diagnosed 2017, still on 2 mg daily prednisone.) I didn’t dare hope but it may be true? I guess I’d need to see what happens with a slow taper toward zero pred?
I’ve lingered on pred because I thought I might still have PMR pain. But I just had X-rays confirming the progression of my osteoarthritis from mild to moderate/severe.
Getting to zero, and no return of PMR symptoms is the only way you will definately know...
In the context of PMR - and adrenal cover - 2mg is still a notable dose. But if you feel well - try a slow taper with 1/2mg and see how you get on. It is the only way to find out.
I will test this out. I also have my 6-month checkup with my endocrinologist (thyroid) in February so that seems like a good opportunity to chat about my adrenals as well.
The answer is this year, next year, sometime, never! Once you have had PMR and it has gone into remission, it is still sitting there and may or may not re-appear.
With luck and continued pacing and lifestyle changes that reduce stress on the body it could be never.For many , it could be next week, next month , next year . And , unfortunately, it's return visit could be for far longer , be more severe, or , more complex than the previous episode.
Good on your Rheumy for understanding this could happen and furnishing you with a prescription. Keep an eye on the date on the pack , when it runs out of date you should have a little mental celebration...... But ask the GP for another prescription , just in case.
Or it could be far easier! Nothing is guaranteed!
Now that would be a New Year gift!
All I know is that all the friends I have who've had PMR twice say the two episodes were totally different!
I’m 72, live in Texas, and understand that nothing is forever. My rheumatologist is great, almost a good friend. I have been following you guys for a while and felt I could great the straight skinny without any sugar coating, Thanks again and happy new year to everyone. May good health follow you and yours.
I see myself as in remission and not cured. If the body’s immune system can go rogue once it could do it again given the right triggers. Having had cancer as well years ago, it seems to be a game of being sensible but not limiting one’s life with arbitrary notions about what one needs to do to keep well. Live life! Ah, but how much? I’ll have to get back to you on that one. I just hope (but not dwell) that lifestyle changes I’ve made and a fair wind will stop it recurring. Eventually as time passes it becomes less of a background thought.
There is no knowing when or if PMR will recur in susceptible individuals. I had a thirteen year remission between my first and second episodes of PMR and now I have been symptom free for over a year.
I put my initial episode of PMR down to stress, got off pred after 2.5 years but back on them after 5 months free because of getting stressed again which brought all the symptoms back. Try to avoid getting prolonged stress, easier said than done but well worth trying!
A period of 5 or 6 months between finishing pred and developing symptoms again is not unusual when the underlying autoimmune cause of the inflammation we call PMR is at a very low level of activity. Even 1/2mg pred per day can be enough to manage it, zero doesn't work though and eventually the dripping tap fills the bcket and it overflows.
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