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Doctors' Answers to "Frequently Asked Questions" - Polymyalgia Rheumatica

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Polymyalgia Rheumatica [posted 1/12/99]
Question: Patient has Polymyalgia Rheumatica and has been taking Prednisone (20 mg/day down to 6 mg/day now) along with INH. Patient had some form of TB infection 35 years ago but has been symptom free ever since. How long should INH be continued?

Answer: Well, a lot of doctors would to reduce the risk of recurrent TB. However, it may be limited by liver toxicity. Hard to know the exact risk and would be less if the person was treated for TB with antibiotics. Coin toss.

Polymyalgia Rheumatica/ Prednisone
Question: I have been diagnosed with having a form of rheumatoid arthritis referred to as PMR. I was on 10 mg of prednisone for about one year and then weaned from it. I have had a re-occurrence of the symptoms, but have fought the urge to go back on the prednisone because I fear the long term effects. Is there an alternative to prednisone that gives the same relief? How harmful is prednisone taken in a 10 mg dose?

Answer: Polymyalgia Rheumatica is an inflammatory disease of muscle almost always seen in patients over 50. Treatment can be non-steroidal anti- inflammatories in mild cases and steroids (such as prednisone) in more severe cases. Steroids such as prednisone will accelerate the aging process. This is more pronounced at higher doses (greater than 15 mg/day), but will occur at any dosage over 5 or 7.5 mg a day. Aging includes increased hardening of the arteries, elevated cholesterol, elevated blood pressure, osteoporosis, muscle atrophy, graying, and fat redistribution to truncal obesity.

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