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Prednisone to Treat Severe Arthritis

written by: BStone • edited by: Diana Cooper • updated: 11/14/2010

In what situations does prednisone and arthritis make sense? When should it be avoided? Learn the effects of this corticosteroid on the body, what the benefits are, and what are the risks.

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    Steroid Medications and Inflammation

    prednisone arthritis Prednisone is one of several drugs that are known as corticosteroids. They are synthetic steroids that have a similar action to the natural hormone cortisol. They have a profound and rapid effect on the body, serving as a valuable form of treatment for several serious conditions, but also causing negative side effects.

    What is the connection between prednisone and arthritis? Why does this steroid medication make sense? Because it decreases inflammation. By reducing inflammation it can help reduce the symptoms of rheumatoid arthritis, but perhaps more importantly, in some cases it can help to prevent joint destruction due to the progression of the disease.

    Inflammation is a natural response of the immune system. White blood cells and body chemicals attack a foreign substance that is causing harm in the body, such as bacteria that is causing an infection. In the case of autoimmune disorders, such as rheumatoid arthritis, the activity of the immune system is out of control, attacking joint tissue and causing inflammation, pain, and even damage to bone. By effecting the immune system prednisone helps to control this natural, yet in the case of rheumatoid arthritis, detrimental reaction.

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    When Prednisone is Beneficial

    Research has found that low-dose prednisone is beneficial for joint symptoms when used for new patients of rheumatoid arthritis. A study published in 2002 in the Annals of Internal Medicine found that after six months of use patients report significant benefits. One and two years after taking this drug, x-rays have shown less joint damage in comparison to patients who were taking a placebo. The study did find however that the arthritis patients who took the corticosteroid were more likely to develop bone fractures.

    Aside from using low-doses to treat early rheumatoid arthritis patients, prednisone or other corticosteroids may be used in severe cases in addition to other medications for the disease such as non-steroidal anti-inflammatory drugs. In these cases the prednisone would probably not be a first line of defense because of the known side effects, but a necessary measure to control the joint swelling and pain or to prevent joint damage. It is typically given in as low a dose as possible and for as short a period of time as possible. Although long-term use can be very detrimental, if arthritis is severe and symptoms are intolerable, patients and their doctors may decide that the benefits outweigh the possible side effects.

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    Side Effects and Possible Risks of Prednisone

    What are the negative side effects of this medication? How likely is someone to experience these effects? Possible risks of taking prednisone include:

    • Weight gain
    • Glucose intolerance
    • Bone thinning
    • High blood pressure
    • Lowered immune defenses
    • Acne
    • Mood swings
    • Insomnia
    • Osteoporosis
    • Swollen face
    • Water retention
    • Blurred vision
    • Cataracts

    The higher the dose and the longer the use of prednisone for arthritis, the more likely that side effects will occur. At the same time, it is important to keep in mind that everyone is different. Some people may be more susceptible to negative risks and even experience more problems, while other patients may have a better experience with prednisone.

    People with other health problems, such as uncontrolled diabetes, an infection, glaucoma, osteoporosis, uncontrolled high blood pressure, or peptic ulcers should not be given corticosteroids to treat rheumatoid arthritis.

    It is important to understand that this medication may be right for some people. Being aware of side effects and talking about all treatment options with your doctor is important as well. There is no cure for rheumatoid arthritis, but by taking measures to improve your well-being and discussing drug therapy and complementary medicine with your doctor, effective management of this disease is realistic.

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    References

    "Steroids to Treat Arthritis." WebMD <http://www.webmd.com/rheumatoid-arthritis/guide/steroids-to-treat-arthritis>

    "Prednisone for Rheumatoid Arthritis" (Annals of Internal Medicine) <www.annals.org/content/136/1/S69.full.pdf>

    The John Hopkins Arthritis Center <http://www.hopkins-arthritis.org/arthritis-info/rheumatoid-arthritis/rheum_treat.html#cor>

    image by Bart (CC/flickr) <http://www.flickr.com/photos/bartificial/122164551/>