Plaquenil vs Prednisone for PMR

I have been on Plaquenil in addition to Prednisone for about nine months.  He added Plaquenil because he suspected I might have LORA (late onset rheumatoid arthritis) which was masking as PMR.  He also said Plaquenil is known to assist in a more rapid tapering of Prednisone.  I experienced no noticable side effects from Plaquenil (which he described as very safe), and have managed to taper down to 1mg (from 20mg) of Prednisone. I wanted to get off Plaquenil primarily because I dont like being on any drugs, and two is two too many.  But i did flare a bit when I stopped Plaquenil briefly a few months ago so I resumed taking it.

As a point of interest, the inflammation had migrated into my hands and fingers which is one reason my Rheumy thought i might have a variant of PMR.  He still wonders whether it is not some other form of inflammatory arthritis.

I dont know if the P

I've had PMR for 3 years also. I'm a 63 yr old female. I am currently on 5mg which seems to be my standard dose. I've had flares, mostly in the fall. It's my stressful time of year, and rhumy said fall is typical for flares. Last year I had a foot surgery in Nov. and 2 weeks later a total hysterectomy etc. I had noticed a little weird foot pain before my surgery on my foot, my other foot hurt a little too, but it wasn't related to the plantar fasciitis surgery. Doc saw nothing during surgery related to the pain. It went away until March. Then it became horrible in May. I had gotten X-rays in the fall on it, had a steroid injection, saw doc again. Nothing helped. My podiatrist and Rhumy were both at a loss. I asked to up my Prednizone to 20mg. I reduced every 12 days. Wouldn't you know in 3 weeks it was gone. I spent months limping.

It's been fine since then. So for me, I will up my Prednizone first before being put on another med with side affects. Others may disagree but you are the one with PMR. You know you body better than anyone. I had to be my own advocate!

Let me add that I was also put on Methotrexate.  I had no positive results, and when I read the laundry list of side effects I terminated immediately.

Many Rheumies believe that PMR is a catch-all for a variety of related diseases that all present themselves with PMR symptoms.  That's why they seem to react in unusual ways when the symptoms migrate into your hands and other extremities.  Some will say if its in your hands it isnt PMR, but many on this forum know otherwise.

 

Sorry Nanduff,     Not able to Help Im afraid

​My Wife has been daignosied PMR and now she has tapered down to 9mg of Pred so far and now beginning to feel it. (Dr wants her to

​reduce 1mg per 4weeks, is this usual).Me, I have had FIBRO over 5 years so far.

​wishing you the best of luck, and hope you manage to sort things out.

 

Plaquenil won't replace the pred - and there is no evidence it helps reduce the pred either. It isn't included in the recommendations for the management of PMR. I suppose if it doesn't cause any side effects for you it may be worth trying it and if it helps, great.

What makes him think it is PMR? I have hand pain occasionally, tendonitis and synovitis mainly. I had it a lot at the start, but it tends to come and go. I've been on pred for well over 7 years, I had been down to under 5mg for a longish time and then had a flare this time last year, back to 15mg and now down to 8mg. No-one here suggests adding anything, they accept you need what you need for as long as you need. I have no side effects from pred and I feel well (as well as we do with PMR that is).

The trouble is, upping the pred won't prove it is PMR - it will help LORA flares too. But like pam - I'm happy with pred which I know all about now. 

Just one point - no-one can be sure it is definitely PMR and not something else. There is no definitive test. I know a few people on methotrexate or azathioprine who can tell the difference if they stop them - but none of them is absolutely sure they have PMR and only PMR. 

Hello Nanduff

I was commenced on plaquenil 29th December 2016, to reduce the prednisolone faster as I have sensitive painful reductions. I think it's because my rheumatologist wants my reduction to be 1mg a week as he says I do not have PMR as I'm 53 years of age, another rheumatologist from Leeds also agrees with him.

I thought I was doing ok until yesterday when I woke at 3am in agony sides of arms legs pelvis lower back and knees, I also developed a severe headache with visual disturbances. I went to gp he sent me to the hospital to see a medical consultant, my esr 26 and crp normal so not sure what is going on. I'm on 13mg of prednisolone and 100mg bd of plaquenil a day. My last reduction 10 days ago of prednisolone. If I've had a flare I haven't had one since ?diagnosed in July by gp but a flare of what?

So in my experience l was ok before plaquenil, I'm now thinking ?stop the extra drug with it's extra side effects.