Steroid Injections....

[Josie2]

Is it possible to just have these all the time and not have to just have them between meds.

Mtx didnt work and made me ill, leflunomide not working and side effects, steroid tablets made me ill too, got to laugh!

Is there any reason you cant just have steroid injections long term? Are there reasons/side effects long term or is it down to cost?

[umamel]

Josie2,

You mean a general injection IM. Not a joint specific injection right?

I have been taking some Steroid injections to add to my 10 mg daily dose of oral tablet form. That had worked for me for three months this summer, and seemed to have less -side effects than the tablets.

I am interested in the answers you will get on this question.

Interesting idea?

Umamel

[earthwitch]

Long term use of steroids carries the risk of some pretty serious side effects, including osteoporosis and adrenal failure. For that reason they aren't generally used as a regular medication unless there is a very very good reason. If you aren't getting enough relief from DMARDs, then your best bet is to ask some very direct questions of your rheumatologist about anti-tnf drugs - they have a far better safety profile long term, and also potentially far better effects, but the NHS does seem to hold off using them far longer than other countries. From what I've heard too the NHS seems to use steroids far more often for RA than other countries, probably because they want folk to try a lot more different DMARDs or combinations of DMARDS first and all the changing around means that you need the extra relief of steroids to cover you while you see if the DMARDs are going to work.

[helixhelix]

Yes, some of the Americans who use this site seem to be quite horrified at the casual way we use steroids. I Think they are treated with much more caution over there, and not used as much. I agree with Earthwitch, it is really not a good idea to have more than around 3 injections a year unless there is really, really no other solution as the possible effects are not good at all. I'm sure the NHS would love to use them, as cheap as chips especially compared to biologics, but not recommended. Polly

[Kathyfitz12]

Steroids are a magic bullet- but have many side effects- my Consultant wrote to my GP asking him to give me a steroid injection to save me the 40 mile round trip to the hospital - the GP refused - writing a long letter detailing his objections!

Can't be down to cost - I got Prednisolone tablets on a private prescription for about £2.50!!!

Could you possible try Mtx again - it really transformed my life and I do read on this site that some people feel ill at first and then suddenly settle down...Good Luck whatever you try.

[Dogrose]

I've had two years of steroid/failed DMARD/steroid/failed DMARD etc. now I'm on track to start taking biologics soon, if there are no contra-indications you should be able to get them on the NHS if you have tried and failed with at least two DMARDS and your RA is still classed as active.

[Hidden]

I don't think steroids modify or stall the progress of the disease in the same way as DMARDs or Biologics can do - they just mask symptoms. As others have said they may make you feel better in the short term but they aren't at all good for you in the long term and they also make you put on weight (moon face). Steroid injections aren't recommended more than 3 times a year max. I agree with Kathy about persevereing - it might be worth trying MTX by injection if you haven't already? I have found MTX with Hydroxy has completely turned my RA round but the MTX made me feel very sick at 17.5 mg so I was switched to injectable and it's really working now at only 15mg - with Hydroxy at 200mg too. These are relatively low doses of two dmards but the combination of both and the injectable MTX (which is significantly more effective if taken in this form according to research) means that it's enough to have taken me into remission.

[Beth58]

Hi

I have AS, Ankylosing Spondylitis with Enthesitis and Osteo arthritis, I take NSAID (Naproxen), a DMARD (Leflunomide)as well as a host of other stuff for various conditions. My consultant wrote me up for a Kenalog injection every 3 month or when needed with at least 3 month between jabs. I think he felt sorry for me as I don't have much quality of life these days. Touch wood it seems to be working ok but I really feel the pain after about 6 wks and can't wait for my next injection.

Beth x

[Victoria-NRAS Partner Moderator NRAS]

Hi Josie

I'm not sure that it's correct to say that steroids only mask symptoms, as I think technically they are a type of disease-modifying drug, so not just symptom control. However, as others have said they are not a good solution long-term, as they carry some serious side-effects if taken in high doses or over a long period of time. Also, if they are over-used they can become less effective, so better to use them when they're most needed and to have standard DMARDs controlling the RA generally. There are a number of DMARDs that you haven't yet tried from the sounds of things, so hopefully you will find something that suits you and controls your RA a lot better soon.

If you'd like to read more about steroids and their use in RA, our article on this may be of interest:

nras.org.uk/about_rheumatoi...

Kind regards

Victoria

(NRAS Helpline)