PMR Flairup after 6 Months free

[skipspmr]

Had PMR for 6 years, then completely free of it and prednisone for 6 months, then PMR came back and went on prednisone for a year, tapering again completely off for 6 months. And now it is back and doctor prescribing 15mg/day for 30 days. This seems to me to be to much prednisone. Comments please.

[DorsetLady PMRGCAuk volunteer]

In that situation we probably would have suggested it was long enough for inflammation to build up again, [6 months seems very common] and to try 5mg.. which probably would have got things back under control. Not a guarantee of course, but likely would have worked.

Think your doctor may be trying to blast it into submission, or thinks it’s a new episode, rather than a resurgence of previous bout. As matter of interest is it same doctor as prescribed you before?

[skipspmr in reply to DorsetLady]

No, but she has my history in front of her. She's new to PMR.

[DorsetLady PMRGCAuk volunteer in reply to skipspmr]

New to PMR .. that probably explains it then… but at least she’s not dithering about. You might find you can taper down part way quite quickly -but as it has a habit of resurfacing maybe a bit more more slowly than last time around…

[skipspmr in reply to DorsetLady]

Thank you,

Skip

[Ps99s]

what ever doseage it takes to be very comfortable is where you start back on and then set a plan for tapering again. Was off pred and comfortable for 10 mo and now suddenly flare and back on it. I know the disappointment.

[Chiqui1950]

Dear skipspmr,

Yes I hear you that 15mg is a lot of prednisone---but this only until you have no symptoms--for me this happens quite quickly if so after two weeks you feel symptom free you may go back to your doctor to retake a tapering schedule as DorsetLady recommends. Also you may ponder on the context of your latest flare as it may give you information as to what to avoid--if possible--- There is a tapering schedule on this forum for a flare that has worked for me --- All the best to you!

[PMRpro Ambassador]

It takes about 6 months for inflammation being created by a very low level of underlying disease activity to build up to a level you can feel. Had you remained on 1mg, even on 1/2mg, it would have kept the inflammation under wraps. We know that Prof Dasgupta in the UK has often kept patients on 2-3mg to reduce the risk of such relapses. For some reason doctors think that 1mg does nothing - but in the case of PMR they are very wrong.

On the basis of my theory - which has had plenty of patients confirming it - I'd take 15 for a few days, 10 for a few days and then 5mg. See how you get on at that and maybe even try lower. But when you get back to 1mg - stay there!