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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is Prednisone advisable for polymyalgia rheumatica?

Hi. I was diagnosed with POLY MYALGIA RHEUMATICA. My Dr. started me on 100mg of Prednisone, decreasing by 5mg, each week, until to pain returns. I got down to 75mg and the pain was, back. I increased to 80 and so far, so good. Is there anything I can do, to assist the Prednisone, so I may be able to decrease, again??
Thu, 31 Dec 2015
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General & Family Physician 's  Response
dear friend

Prednisolone is the drug of choice in cases of POLY MYALGIA RHEUMATICA. there are studies which have evaluated the use of NSAIDs and Methotrexate but the results did not indicate any extra benefit than achieved by prednisolone alone.

It is a chronic, self-limited disorder.

Joint guidelines from the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) conditionally recommend starting corticosteroid therapy with 12.5-25 mg/day of prednisone or the equivalent. A slow tapering of the prednisone, less than 1 mg/month, was associated with fewer relapses. Once prednisone is tapered to 10 mg/day, a slow taper by 1 mg every 2 months until treatment discontinuation was associated with optimal control of disease activity.

so my friend at present there is not enough evidence about any adjuvant therapy which would help you reduce the dosage of prednisolone please keep the tapering slow for a better and longer remission
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Is Prednisone advisable for polymyalgia rheumatica?

dear friend Prednisolone is the drug of choice in cases of POLY MYALGIA RHEUMATICA. there are studies which have evaluated the use of NSAIDs and Methotrexate but the results did not indicate any extra benefit than achieved by prednisolone alone. It is a chronic, self-limited disorder. Joint guidelines from the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) conditionally recommend starting corticosteroid therapy with 12.5-25 mg/day of prednisone or the equivalent. A slow tapering of the prednisone, less than 1 mg/month, was associated with fewer relapses. Once prednisone is tapered to 10 mg/day, a slow taper by 1 mg every 2 months until treatment discontinuation was associated with optimal control of disease activity. so my friend at present there is not enough evidence about any adjuvant therapy which would help you reduce the dosage of prednisolone please keep the tapering slow for a better and longer remission