• Reduce the dose of prednisolone slowly when symptoms are fully controlled. A suggested schedule for reducing prednisolone is provided below, but smaller dose reductions and longer durations at each dose may be needed to avoid relapses in some people. Typically, treatment is required for between 1–2 years.
o For people who are well controlled on 15 mg daily, a suggested schedule is to:
Continue prednisolone 15 mg each day until symptoms are fully controlled (usually 3 weeks), then
Reduce the dose to 12.5 mg each day for 3 weeks, then
Reduce the dose to 10 mg each day for 4–6 weeks, then
Reduce the dose by 1 mg every 4–8 weeks until treatment is stopped.
Scenario: Management | Management | Polymyalgia rheumatica | CKS | NICE
It’s the math.
Minimum
15 mg for 3 weeks, 12.5 mg for 3 weeks, 10 mg for 4 weeks, 9 mg for 4 weeks, 8 mg for 4 weeks, 7 mg for 4 weeks, 6 mg for 4 weeks, 5 mg for 4 weeks, 4 mg for 4 weeks, 3 mg for 4 weeks, 2 mg for 4 weeks, 1 mg for 4 weeks
Total 46 weeks.
Maximum
15 mg for 3 weeks, 12.5 mg for 3 weeks, 10 mg for 6 weeks, 9 mg for 8 weeks, 8 mg for 8 weeks, 7 mg for 8 weeks, 6 mg for 8 weeks, 5 mg for 8 weeks, 4 mg for 8 weeks, 3 mg for 8 weeks, 2 mg for 8 weeks, 1 mg for 8 weeks
Total: 84 weeks
This, ‘suggested’, presented as default, is not merely the 2 years people’s rheumies tell them but the statement PMR can be – should be – done and dusted in under a year or 1.615 years at most.
I understand we here are an atypical selection and there are many many people with PMR not here whose disease might indeed obediently follow a line on a graph but is there actually any evidence for the 46 weeks?
First Appointment with Rheumatologist...
to reduce or not?
Dilemma
GCA tapering
Tapering help sought
