Prednisone Lawsuit in the US.

[Gatorchief]

I was scrolling through mimes on FB today and came across this mime soliciting people that had developed cancer after having been taking prednisone for a year or more. I know there are many risks in prolonged use of prednisone , but cancer was not listed as a frequent side effect in long term use of prednisone. I will say that the legal community in the US has been very active in class action lawsuits against the drug and chemical manufacturing companies here. It seems that the legal system is approving lawsuits alleging that chemicals, drugs, and environmental conditions experienced 50 years ago are considered to be causes’s of many cancers contracted today. I’m not sure what the eligibility criteria is as I didn’t give any of my personal information to find out. I just was curious if anyone here has more insight about this?

[Bridge31]

I’m hoping it’s sheer coincidence ! Evidence ?

Surely you could say that about any drug.

[Gatorchief in reply to Bridge31]

Thank you for replying, that’s my take on it too. After X amount of time on any foreign chemical, some people can develop cancers if used long enough.

[DorsetLady PMRGCAuk volunteer]

At diagnosis, sometimes cancer can be confused with PMR - so, what’s to say it hasn’t been there all long. Plus the older we get [and unusual although certainly not unheard of to get PMR below 50 years] more risk of cancer anyway.

[PMRpro Ambassador]

They are ALWAYS looking for ways to make money like that - thank goodness that culture hasn't spread to Europe yet!

Anecdotally - there is this:

pmc.ncbi.nlm.nih.gov/articl....

But really - how could you say this was pred rather than a host of other historic events not looked at?

I've been on pred for more than a year - 16+ at last count. Nothing appeared yet that I know of. There is said to be an increased rate of cancer diagnoses in the first year after diagnosis of PMR/GCA - but this trend then falls off again. One underlying cause of PMR symptoms can be a cancer which should be ruled out. Then most patients tend to be subect to closer medical monitoring - so more likely to be found.

This

aacrjournals.org/cancerprev...

modifies the claim with MIGHT.

In the past, studies suggested the risk might be lower in RA patients. But an association is likely to be seen given the vast numbers of patients who receive treatment with corticosteroids for immunosuppression.

[SnazzyD]

I guess it’ll come down to whether it was known at the time but was suppressed or the risk benefit calculation wasn’t explained to the patient. If you have to suppress the immune system for a good reason, then cancer may well be a risk that is taken willingly. Currently, Pred is still all we’ve got that is as universally good at this job and it is cheap. I hope money grabbing law firms don’t cause Pred to be too risky for doctors to prescribe.

[PMRpro Ambassador in reply to SnazzyD]

They are already averse enough!!!!!

[Omakaat]

Well, I do have a three monthly appointment with a dermatologist. He is convinced that the speed my spots of skincancer pop up and grow is directly caused by my prolonged use of prednisone. Just had stitches removed today and already on the list for December. So it is a good idea to see a doctor when you don’t trust that little spot that keeps returning.

[Gatorchief in reply to Omakaat]

Thank you for replying. I already had two spots removed back in 2015, one was a Basel Cell and other one was a Squamish Cell. I see the dermatologist yearly and so far I haven’t had any repeat growths. I should probably start going in at-least every 6 months now that I will be on prednisone for who knows how long.

[PMRpro Ambassador in reply to Omakaat]

Although work done 20+ years ago postulated a link, a more recent study in Denmark I think looked at that and found no link. A more recent US study also found no link between BCC and pred in younger patients and that was consistent with finds in older patients too, though there was a stronger link with SCC. But the evidence is inconsistent.

Pred does tend to make you more likely to burn - probably due to the thinning effect on skin - and we have always recommended sunscreen and avoiding direct sun. But it is difficult to be definitive - what was anybody's history of sun exposure? Cancer is related to a dodgy immune system - we have a dodgy immune system in PMR. Is it the pred or the autoimmune part of PMR? I had a top to toe check just over a year ago, a few seborrhoeic keratoses but nothing else after 15 years of pred.

[Gatorchief in reply to PMRpro]

Thank you! I’ve started to tapper my dose 4 days ago from 15mg after 8 weeks. I’ve been on 12 1/2 mg for 4 days with no pain issues. I’m hoping to stay at 12 1/2 for the next 3-4 weeks before reducing to 11 mg . My hope is that the lower the dose the less chance a skin problem will develop. We’re heading into the winter months now so my Sun exposure will be limited for the next 5 months and I could possibly taper to 7 1/2 mg by then. That is if my theory if the less the dose of prednisone, the better chance the immune system will help in fighting off these problems.

[PMRpro Ambassador in reply to Gatorchief]

But you need what you need - taper the pred too fast because of a relatively minor problem and you will risk the problem of the disorder the pred is for returning. Use sunscreen ...

[Gatorchief in reply to PMRpro]

Thank you, I will.