Side Effects of Corticosteroids

[craighead72]

I found this site very useful as a summary of potential side effects of corticosteroids such as Pred which most of us are on during our PMR journey.

cortisone-info.com

[DorsetLady PMRGCAuk volunteer]

cortisone-info.com/en/home/

This link may work better...

[Exflex]

Thanks!

Leads me to a question. What’s the chemical difference between natural cortisol produced in the adrenal glands and corticosteroids?

I believe the main cause of PMR is IL-6. Natural cortisol doesn’t help, but corticosteroid does.

Hadn’t thought about until now. Anyone here able to add to this?

[PMRpro Ambassador in reply to Exflex]

Cortisol doesn't have as strong an anti-inflammatory effect as other corticosteroids. Hydrocortisone is the synthetic version of cortisol so is the same structure. Prednisone must be processed in the liver to produce prednisolone which is the active form. Other corticosteroids are even more powerful anti-inflammatories.

[Exflex in reply to PMRpro]

If I remember from my exposure to chemistry back many years ago, chirality and physical shape play an important role in bio chemistry. Without the ability to analyse the signature of IL-6 in that sense, and that of corticosteroid, I suspect it’s jigsaw pieces locking together.

I wonder if the pharmaceutical industry has investigated an antagonist that can block IL-6 without the damaging effects of the cheap as chips corticosteroids?

[PMRpro Ambassador in reply to Exflex]

It is a biologic called Actemra, substance name tocilizumab. Costs about £12,000+ per year. It is approved for use in RA and GCA but in the UK use for GCA is restricted to repeated relapses and for a maximum of 1 year. It is used more in other countries. There are a few other IL-6 antagonists which are equally expensive and haven't been submitted for trials in GCA/PMR

[Exflex in reply to PMRpro]

That’s expensive chemistry!!

[PMRpro Ambassador in reply to Exflex]

Biologics are expensive to develop. The price will come down - Humira was a similar price but my rheumy tells me it is now about £700 a year.