PHILADELPHIA – The use of prednisone therapy, especially in high doses, increases the odds that a person with rheumatoid arthritis will develop an infection, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in Philadelphia, Pa.
Rheumatoid arthritis is a chronic disease that causes pain, stiffness, swelling, and limitation in the motion and function of multiple joints. Though joints are the principal body parts affected by RA, inflammation can develop in other organs as well. An estimated 1.3 million Americans have RA, and the disease typically affects women twice as often as men.
Researchers recently compared the use of different combinations of immunosuppressive RA therapies, specifically TNF inhibitors and conventional disease-modifying antirheumatic drugs (commonly called DMARDs) such as methotrexate, leflunomide hydroxychloroquine or sulfasalazine, TNF–inhibitors (i.e., infliximab, etanercept, or adalimumab) and corticosteroids, including prednisone, to the risk of infection in people with RA.
Researchers used both the VA National Patient Care Database and the Pharmacy Benefits Management Database to identify cases of RA from October 1, 2000 through September 30, 2007. By definition, patients with RA had had two outpatient visits at least 30 days apart or one inpatient visit, and had had at least one prescription for a DMARD. They determined that approximately 35 percent of patients are on prednisone, which is mostly used in those whose RA is difficult to control with DMARDS or TNF inhibitors alone.
http://www.rheumatology.org/about/newsroom/2009/2009_am_01.aspI remember once I went to the orth surgeon for a Kenalog [cortisone] shot in a joint in the hand. He saw that I had a bad cut in the general area and that it was inflamed. He gave me an Rx for antibiotics and told me to come back in a week and then he would give me the Kenalog shot.