Seal49

[Seal49]

I was diagnosed with PMR about 6 weeks ago. My Dr. First tried the 6 day pa c k of prednisone with stopped working when dose lowered. Sent me to a Rheumatologist about a month ago and he started me on daily 30 mg prednisone. Reduced me to 27.5 2 weeks ago and today when I saw him he wants to have go down to 25 mg and them continue to go down by 2.5 mg every 2 weeks until I get t o 20mg daily. While doing this he wants me t o start taking an additional drug called SSZ (sulfasalazine) and get off prednisone asap. I generally feel good all day but still start the day with some leg stiffness for about an hour. He keeps saying it my not be PMR but rheumatoid arthritis I instead. Has anyone ever taken SSZ and what their experiences. Gave been. Not sure what do.

[DorsetLady PMRGCAuk volunteer]

Why is there a query about it being PMR? Has he tested for RA?

Your reaction to the first trial of Pred would indicate it was PMR….. and it is quite natural to have some stiffness first thing in morning until the Pred has time work.

Cannot help on the sulfasalazine, sorry, but others will be along in due course.

[PMRpro Ambassador]

IF it is RA then I see the point of trying another drug instead of the pred - but why sulphasalazine I wonder? The rheumy wanted to put me on sulphasalazine but I was about to move to Italy from the UK and hadn't got a specialist here and you need specialist care for monitoring. One of the warnings with sulphasalazine is to keep out of the sun - not really helpful here so I wasn't keen anyway. No-one else has ever suggested that again.

Please - can I ask you not to use your forum user name as the title of your posts. Please give a short outline of your question/problem - you are more likely to get relevant replies and the site will also flag up related posts from the past.

[Rachmaninov2 in reply to PMRpro]

I have PMR and Inflammatory Arthritis, and when discussing a change from oral Methotrexate to injections my rheumatologist did suggest sulphasalazine instead. I decided to continue with the Methotrexate.

[Prof99]

Hi Seal, although Prednisolone seems to work well for the majority - the effectiveness of the 'additional drugs' seem to vary greatly for each individual. I was put on Sulphzalazine back in 2020 but it sent my liver function levels well off the scale so I had to stop it. Having said that, I have read, on this site, that there are plenty of others who get on well with it. I also couldn't tolerate Azathioprine - which, once again, others have found worked for them. I have now been on Methotrexate for about 2 years and this is working well for me (as I discovered to my cost when I tried to reduce the dosage earlier in the year). As Rheumatologists seem to offer additional drugs in the order of Suphazalazine & Azathioprine before Methotrexate - I am hoping that the Sulpha and Aza are less harsh on the body than Methotrexate - which they may offer only if the others don't work. However, the cynic in me says - they just may be cheaper drugs than MTX! My advice would be to give it a go but make sure you have regular blood tests to check your body is tolerating it.