Questions about prednisone side-effects (hard data)
This might not be the right place to ask, but I'm looking for information to understand why physicians are so reluctant to treat PsA with prednisone long term, and insist on what seems an increasingly dangerous progression to ever more expensive drugs that are less effective, less reliable, and seem to have worse side-effects and pose much higher risks of sudden death by normally harmless infections.
I know (first hand) the immediate side effects of prednisone, and find them quite manageable (if not always pleasant), but can find NO actual hard data on the frequency of prednisone side-effects that would seem to back up the reluctance of physicians to prescribe it these days.
Call me cynical, but I begin to suspect that the entire aversion to prednisone is because it is cheap, and Big Pharma doesn't make any money from it.
You bring up a good point and I'm sure others who are better with science and studies will also add their thoughts. I think I've just taken for-granted that doctors thought long term steroid use wasn't good- or worth the risks.
So after some searching from reputable sources and finding the right search terms, I did find this article from a medical journal. Here is the link https://www.ncbi.nlm.nih.gov/books/NBK531462/
But let me warn you if (like me) "science" isn't your first language, you might find it rather verbose. However, if you scroll about 1/3 of the way down, you will find several paragraphs, each detailing some of the possible complications from long-term steroid use. Including osteoporosis, metabolic and endocrine complications (such as increased risk of diabetes), pituitary and adrenal gland issues, heart issues, glaucoma, not to mention even depression.
That being said, I have been on a ridiculous amount of steroids over the years. There are also quite a few here on our site who have had great success with long term, low dose steroid use. I'm sure they will chime in here too.
Balancing the scales of risk and reward with psoriatic arthritis is very difficult and just one of so many decisions we have to make. Do you have a good relationship with your doctor? Have you spoken with him/her about it? - Leanne (Team Member)Thanks, Leanne! Actually, science is my "second language," if not my first, I have a doctorate in environmental science and engineering. 😀
I saw other articles like that one, but as you mention, most of the serious side effects are from high dosages, over prolonged periods of time. Even then, I could not find any hard numbers attached to anything, as in..."x percent of patients who took prednisone at dose y, developed condition z after time t" sorta thing, with regard to either high doses, or low doses. Just generic "have been seen to develop" sorta relationships that don't really tell you much, when you consider all the potential other medications and dietary nutrients people were taking at the same time.
Thanks again!
Ken
