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Robert Kimelheim

| Nov 12, 2023 4:44 pm

Sir. Thank you for concisely addressing the soup to nuts failings we share in this rather common disease. For many years we have tenuously drifted through diagnostics treatment, monitoring and after care. You can't deny that classic patient who improves as the pharmacist is handing them their prednisone. Even the Family Doctors have this down (though why they start patients on 40 mg Prednisone?).

One observation I have made and it is consistent, and almost without fail, is that PMR patients, prior to the onset of the disease are extraordinarily healthy. And this is in a population of older/elderly. They may be on maintenance meds for this or that, but they have active and dynamic lives. Male or Female.

Another observation is that I see new PMR patients in clumps - not necessarily the same season, but will come in "one after another" for 1-2 months then quiet.

I have had a handful, a very small handful, who have elected no Rx, or NSAIDs and otherwise choose to ride it out, but I suggest after reading the above, that we may not be seeing those with low disease activity.