Long-term Prednisolone use.

[Frankiefocus]

Just a quick question is it normal for a consultant to keep a patient on Prednisolone for over a year? I have been reading a lot about this drug and it's supposed to be short-term. My daughter was diagnosed with RA and I was shocked to discover since last March 2020 she was on 20mg a day reduced to 10 mg and her pains have worsened. Any advice welcome.

[Kalimera57]

That can’t be good for her. Steroids thin your skin and are bad for your bones and I believe can contribute to cataracts. The consultant sounds sloppy.

[LoneEra]

You might find the replies on this post helpful: healthunlocked.com/nras/pos...

Sometimes long term steroids are the only “glue” that holds someone together - especially if the right RA treatment hasn’t yet been found.

But your daughter should certainly chat with her specialist and see what other options are available to her going forward x

[Lolabridge]

I have been on it for nearly 3 years but needed it whilst we found an RA drug that worked well for me and the first four did not. So I hope your daughter is in the process of trying out the RA drugs to find the right one for her but, sadly, it’s trial and error and can take a while. When she’s discovered which work well for her she will be able to start to taper off the Prednisolone.

[Deeb1764 in reply to Lolabridge]

I was the same plus asthma issues but now weaning off the stuff but definitely ask for a review.

[sylvi]

I have been on them for years. I have finally got it down to 5mg until i get a infection then i have to have 30mgs a day for 7days. xxxx

[AgedCrone]

Ask the consultant very firmly to review her meds with the intention of weaning her off Pred...the longer on it...the harder it will be to reduce.It won’t won’t be easy ...but your daughter will be really pleased when she manages it.

[medway-lady]

That is not a big dose but not good for the bones etc. has she been prescribed anything to protect them? and is she diagnosed with RA ? as usually they are a short term fix not a medication to actually treat RA. they are addictive and it takes time to wean off them, so yes that could make her feel really rough. Has the consultant prescribed anything else and been in contact over the past year ? as it does sound odd. But of course with covid it is difficult although that should not be the excuse for not keeping track of a patient.

[KittyJ]

Yes I was on pred for nearly 30years, half of that at a low dose like your daughter. I don’t think they would allow that now as they are more aware of the risks but many on here are on them for a couple of years whilst trying different meds to get their RA under control. Your daughter should speak to her rheumy to let them know her other meds aren’t working as well as they should, maybe she needs to have her dose changed or another med. Either way if she doesn’t tell them they will assume she’s doing ok.

[allanah]

Ive been on high dose for a few years then 5mg per day for about 8 years. If doc changes it i end up in hospital. So we are all different and some cant get by without, however she can chat about any aspect of her treatment with her rheumatologist .

[Neonkittie17]

I was on Pred for 10 months, after 2 months of 20 to 5 mgs. The remaining 8 months were a slow taper so sometimes it can take a long time.

[Brushwork]

It is definitely not good practice. Steroids should be used with caution. However, it is an 'easy' way to keep patients free of pain and it does control inflammation so it is a balancing act. They are often used to keep the inflammation at bay while an effective medication is found.Personally, I have refused to take them, I will have an occasional intramuscular steroid injection, when I am flaring badly.

[BoneyC]

Yes some people take steroids for years, others short courses now and then. I know a transplant patient who is on Prednisolone for life.

[Hidden]

She should really be considered for medicine to control her RA not just a steroid which should not be used as a long term solution. Have a word with your GP or Rheumatology team.

[Angels54]

Hi I have been on and off prednisone for 5 yrs, I have now developed osteoporosis in my back , I had good eye sight now had cataract on both eyes , I am now in my late 60 s ,I was on 10 mg and I have reduced to 5 mg and now 2 mg hoping to get off it myself soon , however this is something you just can’t stop it has to be a gradual thing , the other thing is when you in so much pain it is a quick fix and helps with pain , make sure you have vit D depending on age , look for other things that might help relieve pain Hope you get some good advice soon ..

[Kags1068]

Hi Frankiefocus

Unfortunately, yes it does happen for some of us, but nowadays not usually as a long-term first line of treatment. I've taken them for 28 years now (alongside various DMARD's and biologic), but it was because of eye complications and aggressive disease - a last resort rather than a first! My understanding is that they now tend to use them for a short time whilst waiting for a DMARD to kick in? Has this not happened for your daughter?

I hope you can get some answers, and a better treatment plan for your daughter. 🤞

[Paisley58]

Steroids causes so much damage, my first consultant did this to me only he kept putting mines up everytime he saw me; weight gain, moon face etc. I was in a state when my GP decided to refer me to the rheumy I am with now. My rheumy was so angry I had been given steroids for four years with no protection for my bones either. He weaned me off them and told me that it's a lazy doctors treatment, that they are for short term use. It makes me so mad when I see doctors doing this to patients without warning them or changing when they can see it's not working. I hope your daughter recovers soon, sending love and light