prednisone | Arthritis Information

 

hi all just wonderd if any one else is on prednisone as the only med
for ra...  and is it working...   Boney
I was on 5mg of pred, because that was all I could afford, back when I had no insurance. It helped, but was not as good as it is now being on Remicade, Imuran & 10mg of prednisone.

hi joonie thanks for the reply i can not get biologics due to pred and low inflamation
i have used all the other dmrds so i am left whith just prednisone.. so i wonderd
anyone else in this position and is pred slowing down joint destruction long term..


How long have you been doing this Boney? Predisone use long term isn't really recommended. I'm sure you are under a doctors care and I'm certain your doctor knows best.....but we do hear a lot of about long term predisone use and I would think predisone as your only course of action long term wouldn't be your best option. Well, when I was taking just pred for about 6 months, it did not really help slow down anything. It helped a little with the pain and stiffness, but did very little for inflammation. I was still severely swelled and fingers did not bend because of the inflammation and knees swelled to the size of grapefruits. By the time I got to see a RD the inflammation was in my muscles. So, I was took off prednisone for as long as I could stand it, which was close to 2 months, then I was put back on at 15mg and started on Humira. joonie2008-04-01 13:55:29hi lovie i am 48 have severe erosive ra 13yrs  and been on pred 13yrs... 2 yrs ago i had very bad reaction to a dmrd and was not given another. so i was left whith pred and medrol injects
for a year..  then things got bad so i started  complaining inthe hospial they restarted mtx
but i had 8mths of chest infections .. then i restarted arava  and  had a bad reaction to that.
as i say they will not give me biologics...  anti tnf   due to pred use and low inflamation...
i am in the uk...  i think the only med i have not tried is  cyclosporin..  unsure why..
as i can not get biologics i have nothing left to take...   end of the line so to speak...
even the medrol injections have now been ceased due to an effect on muscle in my leg
and pressure in my head...so i wonderd any 1 else out there stuck in this situation..


HI Boney, like you I have had no end of problems with all the Dmards and biologics, I haven't tried cyclosporin either but my GP won't let me try it, says it is much too toxic.  I have been mainly on pred only for 8 years with in between bouts of this and that, my RD reckons that it has helped to slow down the damage, but it has caused untold other problems, osteoporosis, cushings syndrome, pre-diabetic, obesity, glaucoma, blood pressure, cholesterol probs, etc etc, so we have been trying to keep to the lowest possible amount, my ESR is always raised as I can no longer take antiinflammatories either.  All I can suggest is keep yourself informed and take the pred while you have to.  I am managing MTX this time around, so far but like you usually end up with infections, or intolerance.  All the best, hope this helps.  It does help with the stiffness and inflammation but not enough to keep me pain free.  Regards Janie. have you tried Minocin aka AP Therapy? It helped with my swelling some, but I came off of it because I was having hip troubles/balancing and minocin made me lightheaded. I did not want to risk falling, last time I fell I broke an elbow. Boney. Pred is good for short term relief of inflammation. But long term, this med will destroy your body, inside and out. Please look further to see what else may be available to you. Pred should be last resort.I have been on arava for a while, but mostly pred for the past 3 yrs.  It was the only thing that worked on me out of all the trials.  Right now i am on arava and it is starting to kick in very very well, but i still need prednisone cuz i am nothing without it.

Study Reveals Why Bone Loss Occurs During Steroid Treatment.

LITTLE ROCK, Ark., July 14 /PRNewswire/ -- Every year millions of people in the U.S. receive steroid therapy for such conditions as asthma, chronic obstructive pulmonary disease, rheumatic diseases, and multiple sclerosis. However, long-term steroid treatment causes severe side effects, the most serious being osteoporosis, a debilitating condition of bone loss resulting in fracture. Now, researchers with the U.S. Department of Veterans Affairs (VA) Central Arkansas Healthcare System in Little Rock and the University of Arkansas for Medical Sciences (UAMS), find that steroid-induced osteoporosis arises from changes in the numbers of bone cells available to maintain bone. The findings could provide new clues for future therapies. Study results appear in a cover story in the July 15 issue of the Journal of Clinical Investigation.

Millions of Americans have no choice but to begin and stay on steroid-type medications for life-threatening diseases. Such treatments protect those who receive transplants from rejecting their new organs. Typically, the therapy is needed for many years.

But no matter what the age or gender of these patients, they all can expect the same side effect from taking steroids -- serious bone loss or so called osteoporosis -- a condition that slowly weakens the bones and eventually causes fractures. More than one-third of patients taking steroids for more than five years have fractures. For the past 60 years, physicians have known that steroid-induced osteoporosis is one of the medication's side effects, but why it occurs has not been clear until now.

"The discoveries described in this paper represent an important finding as they open the way to tackle a serious medical dilemma that involves millions of people: how to get the many benefits of steroids without devastating the skeleton. Basically, our findings revealed that when animals or humans take high doses of steroids, not only fewer bone-forming cells are made, but they are dying prematurely," said Stavros C. Manolagas, M.D., Ph.D., the associate director of the VA Geriatric Research and Education Clinical Center, and UAMS Director of the Division of Endocrinology and Metabolism and the UAMS/VAMC Center for Osteoporosis.

"This discovery follows our earlier breakthroughs explaining how women lose bone after menopause and how both women and men develop osteoporosis with old age. It confirms our general idea that the fundamental problem in all forms of osteoporosis is abnormal birth and/or death of bone cells," continued Manolagas.

Dr. Manolagas says further, "One very exciting prospect, now that we know the nature of this particular problem, is the development of 'designer- steroids' that will have the inflammation combating properties of the existing steroids, but will not have their bone killing effects, in other words, they will be bone sparing.

"This idea is similar to what is already a reality in the case of postmenopausal osteoporosis, where physicians now have available for their patients 'designer estrogens' that protect the skeleton, but do not have the breast cancer risk associated with classical estrogen," added Manolagas.

"Our study shows that steroid-induced osteoporosis arises from changes in the number of bone cells available to maintain bone. This disrupts the stability of bone, causing eventual fractures and, also, collapse of large joints," explained Robert Weinstein, M.D., a staff endocrinologist at the VA Central Arkansas Healthcare System. He is also a UAMS professor and first author of the paper.

"No bone is spared from the steroid-induced bone loss, but the effects are more dramatic in the spine and in the hip. Unlike common age and gender- related types of osteoporosis, this form of the disease occurs at any age, even in children," continued Weinstein.

"Not infrequently, patients who take steroids for many years end up in a wheelchair. Yet, a recent survey of physicians showed that most underestimated the risk of glucocorticoid-induced osteoporosis in men and women. Only 25 percent ranked osteoporosis as one of the top three side effects of high dose glucocorticoid therapy in a 45-year-old pre-menopausal woman, and 8 percent ranked it as one of the top three side effects in a 45- year-old man.

"Like all problems, knowing the cause makes it a lot easier to figure out the proper defense. We got our clues first from studies with mice. We found that death of bone-forming cells was occurring even in normal bones, but at a very low rate. We were totally amazed when we saw the devastating effect of steroids on the survival of these cells in sections of bone under the microscope."

Weinstein said the UAMS/VA team repeated the findings to be certain that they were exactly what they were seeing, and there were no quirks in their measurements. The researchers were gratified and relieved when they saw exactly the same thing in biopsies from patients who had osteoporosis from taking steroids.

Two other team members who are co-authors in this paper, VA research scientist Robert Jilka, Ph.D., and UAMS professor of medicine Michael Parfitt, M.D., made important contributions to these studies. Dr. Jilka reproduced the findings in a cell culture dish and he found that steroids decreased the birth of new cells. Dr. Parfitt determined that the rate of cell death caused by steroids was high enough to have the devastating effect seen in the bones.

hi linb  thanks for  taking the  time for all the information.. i have read about the side
effects but not as much detail as you have given...  it is scarey stuff but what can we do
thanks for the wake up call about vigilance of side effects..  after 13yrs you tend to put it all
to the back of the  mind...i shall be pushing for a dexa scan as i had my last one 5- 6 yrs ago

wishing you well  ...Boney
I have osteopenia but I don't think it's from predisone use. I've had RA for 14 years now and been on and off perdisone more times than I can count. My use was always short term courses only though. Never long term but the doctors still wonder if that, other RA medications (DMARDS) or just the RA alone has caused it.
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