Prednisone

Prednisone & Rheumatoid Arthritis

What is rheumatoid arthritis?

This is a chronic or long-term disease of the joints. It is progressive and slowly grows more painful as the inflammation spreads and the joints swell. The cause is a fault in the body’s autoimmune system as the white blood cells attack the heathy cells in the joints. At present, there is no cure. The best that can be done is to slow down the progression of the disability.

Why use Prednisone?

As a steroid, it helps to relieve the inflammation and reduce the swelling that forms around the joints. Because Prednisone suppresses the immune system, it slows the damage to the joints. Further, as the inflammation causes pain when the joints are moved and the swelling restricts movement, Prednisone improves mobility and improves the quality of life.

What are the benefits?

There have been a number of recent clinical trials which show that Prednisone does more than simply relieve the symptoms. Because the body’s immune system is suppressed, the damage to the joints and the surrounding bone slows almost to a stop. The message seems to be that, if you begin taking Prednisone before too much damage is sustained, there will be a significant improvement in outlook. But, since Prednisone does not repair the damage, it cannot “cure” arthritis. Thus, the maximum benefit comes by taking a very low dose of Prednisone for a significant period of time.

What are the problems?

If you take Prednisone with other drugs, there can be real long-term problems, even if you are taking Prednisone at a low dosage. Further, the longer you take Prednisone on its own, the more likely it is you will begin to put on weight, lose some bone density and run into diabetes and heart disease. The drug is also associated with mood changes and, over time, some people find themselves growing depressed.

How long should you take Prednisone?

This is always a balancing of costs and benefits. If side effects do appear, you should always taper the dosage and slowly stop using the drug. There is no evidence that there is real value to starting on Prednisone more than two years after the arthritis first appears. But, if you start taking Prednisone soon after diagnosis, it is appropriate to take the drug for up to two years at low dosage — longer if there are no obvious side effects.