Hi DJ and welcome!
First the figures again (just in case you haven't seen them, I never know which threads I've put them in!): about a quarter of patients are able to reduce their steroid dose to zero in about two years or less but then have a higher likelihood of relapse later, requiring steroids again. About half are on steroids for around 4 to 6 years but rarely seem to have a relapse (or they don't return to the doctor if they do) and the rest need longer term steroid treatment. So 2 years is an optimistic view but it does happen.
The concept of "careful drug management" is irrelevant here - the pred doesn't cure the disease, PMR is the name for the symptoms (medical latin for many painful muscles) of an underlying autoimmune process that causes inflammation and swelling as our immune system goes haywire and attacks us in error thinking the cells are invaders. There are many such illnesses (PMR, lupus, rheumatoid arthritis, diabetes), the symptoms depend on which cells are being attacked. Pred is used to manage the symptoms until the underlying disease goes into remission - which is the main reason for always trying to reduce the dose to the lowest possible dose that leaves you able to function. Reducing in small steps and allowing a decent gap between reductions means you don't overshoot the mark and allow a flare to get going which would then require a return to a higher dose and starting all over again. But the bottom line is: if the underlying disease is still active, the symptoms will return without pred.
There are ways of helping the pain and stiffness without steroids - but you still tend to be quite restricted although I managed to ski during the 5 years I had it relatively mildly (for some reason the action in skiing really helped the hip stiffness) the last 3 years have been increasingly difficult although there are other factors involved. You don't say if you are male or female - men tend to have a different course from women, often easier. We do tend to assume new people are women as 3 times as many women develop PMR as men!
There are other drugs which some doctors will use to reduce the steroid dose for patients with other medical problems where steroids pose risks - as is the case for you. There has been a small-scale trial with leflunomide in which 22 out of 23 patients went into remission when given this drug (Arava) which is used for rheumatoid arthritis and psoriatric arthritis. In them, it doesn't cure but slows the disease process. I don't know if going into remission on a long term basis counts as a cure - and the pilot study is relatively recent so there are no long term studies.
This is the abstract from the paper on this study:
"Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are related inflammatory rheumatic conditions affecting adults over the age of 50 years. Both conditions respond to initial glucocorticoid (GC) therapy. However, most patients require 12-36 months of a tapering steroid regime. Adverse events at 2 years are seen in up to 65% of patients with PMR and 86% of patients with GCA with over 50% developing serious events. There is also a high incidence of relapse in both diseases -40% within 2 years for GCA and 50% of patients with PMR at some point having a relapse. Effective steroid-sparing adjuvant therapies are urgently required especially in incomplete, poorly sustained or non-responders to glucocorticoids. In this case series, we found that Leflunomide is efficacious, with 22 out of our 23 patients exhibiting a complete or partial response. It was also steroid sparing and well tolerated. It may be a useful adjunctive agent in difficult-to-treat GCA and PMR. Prospective randomised controlled trials of Leflunomide in both GCA and PMR are now required." (Efficacy and tolerability of leflunomide in difficult-to-treat polymyalgia rheumatica and giant cell arteritis: a case series. Int J Clin Pract September 2012)
This study was done in the rheumatology department at Southend Hospital in Essex and the head there is very closely associated with the National PMR/GCA charity. Your rheumatologist may be interested if s/he hasn't seen it yet. I haven't checked how leflunomide and glaucoma are related.
My personal experience is that my eye pressures haven't been affected at all but I don't have glaucoma. Something at the back of my mind tells me someone on here has had problems and it is monitored very closely but she still takes pred. There is also someone on the other forum with eye pressure problems on pred. But both of them had GCA - and there it is a case of you're damned if you do and you're damned if you don't. Pred is the ONLY answer to GCA when it threatens the optic nerve which puts your sight at risk.
The other thing you haven't told us is where you live - don't need your address, just area - but there may be a support group near you and talking to real people is very helpful! We can also suggest the best person in your area if you have difficulty in finding someone who really understands PMR and how debilitating it is. Many doctors don't get it - we tend to look very well!
I'm sorry we sound so depressing but these are facts that can't be escaped. Do tell us how you get on this evening because it is all adding to our pool of knowledge.
Good luck,
Eileen