Shoulder niggles again

[artisam]

Rheumy has me on quite a fast taper, but as he has added Lefluminide into the mix I’ve gone along with it. Been fine until 7 mg, but now shoulder niggles have started to creep in. It is mainly my right shoulder and wakes me in the night. This morning both my shoulders are stiff and pred does not seem to be kicking in. So clearly not enough. My question is should I just go back to 8 mg for a while and see if that improves it or should I add more? I don’t see him again now until July and the GP seems happy to let me repeat my prescription. Thank you in advance for your advice.

[DorsetLady PMRGCAuk volunteer]

A return to 8mg might catch it -really depends how much inflammation has been allowed to build up. Could try for a few days and see.

However if it doesn’t - then usual advice add 5mg for 7-10days (14 maximum) - then back to 7.5mg or 8mg -as 7mg was not quite enough.

[artisam in reply to DorsetLady]

Perfect. Thank you. 🙏

[PMRpro Ambassador]

Does the rheumy think the LEF will allow you to taper quickly? How long have you been on it? Some seem to think that they can start a DMARD and immediately start to reduce the dose of pred. Unfortunately, it doesn't work like that!!!

It can takes some time to build up to have any effect and until then, you need enough pred. And it doesn't work for everyone with PMR - whatever Baskhar Dasgupta's very small study appears to show. One friend who is on it says she felt it literally "kick in" - she felt a difference on a specific day.

[artisam in reply to PMRpro]

Im on my second round of PMR, different rheumy. He thinks the LEF will stop me relapsing again. I’ve been on it for about 4 months now. Not sure what it’s doing, but it’s not causing any problems either. I asked him what he suggests if I’m flaring - he said take painkillers and don’t increase the pred, so I’m not that confident he knows what he is talking about!

[PMRpro Ambassador in reply to artisam]

No, me neither! Not if he thinks painkillers work in a PMR flare. Obviously doesn't quite understand the mechanism does he?

[artisam in reply to PMRpro]

Ha! No he doesn’t.