Steriods

[Augustus-6]

7 years ago i had 5 stents and a year ago i got angina. For 2 years ive been taking predisilone 5 mg fot rhumatoid arthritis but i got pancreatitis and was told steroids can cause it so i stopped them and the angina has gone. Has anyone else experienced steroids and angina its very odd!! But now i have the arthritis back. 😕

[PMRpro Ambassador]

As far as I can gather it is very rare - but it can happen.

jstage.jst.go.jp/article/in...

I have had atrial fibrillation for most of the time I've had PMR, initially without pred at all. Currently it seems to be quite bad at 7mg/day, less of a problem at 8mg and absent at 9mg. This is a fairly new event, since my last flare. Wondering what the quacks will come up with!!!!

[Augustus-6 in reply to PMRpro]

How strange. What is artrial fibulation? I rember my rhumatologist saying pred is bad for the heart but he wanted to put me on his own cocktail and at the time i wasnt sure if i believed him but i do now.

[PMRpro Ambassador in reply to Augustus-6]

My atrial fibrillation has NOTHING at all to do with me having been on pred - it already existed 5 years before I ever got to take a single dose of pred.

Atrial fibrillation is caused when the electrical cells in the heart do not fire properly and trigger the nerve supply in the walls of the chambers of the heart to contract and relax in time to push blood from the atria (the smaller upper chambers of the heart) into the ventricles (the larger lower chambers) and then on around the body. Depending on the type of misfire the atria, the ventricles or the entire heart can be affected. Sometimes a pacemaker can be used to sort it out, sometimes not.

While steroids CAN cause cardiovascular problems, not using them when a patient has vasculitis can lead to worse damage in the cardiovascular system in general. It is a case of judging whether the benefits of their use outweigh the downsides. Mostly they do and in the case of GCA, in particular, not using steroids can also lead to stroke and other c/v damage and even death.

Your rheumatologist may have his own favoured cocktail of drugs - which may work in some disorders. If it doesn't include pred, I doubt it works particularly well in PMR and is unlikely to cut the mustard in GCA where corticosteroids really are the mainstay of management and remain so - despite tocilizumab.

[Asbeck in reply to PMRpro]

As usual very understandable. Thanks.