About Prednisone & Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune condition that causes progressive damage to the joints, usually accompanied by significant pain and swelling. Prednisone, a prescription-only corticosteroid is sometimes used to treat rheumatoid arthritis. Corticosteroids are useful in rheumatoid arthritis because they act as both anti-inflammatories and immunomodulators, but they are associated with some significant side effects.
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Function
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Prednisone has two modes of action against rheumatoid arthritis. First, it reduces the inflammation of the joints caused by the disease; this also improves pain, which is exacerbated by local inflammation. Secondly, prednisone acts as an immunomodulator, which means that it affects the immune system. As an autoimmune disease, rheumatoid arthritis is cased by immune cells attacking healthy cells in the joints. Prednisone can inhibit the action of the malfunctioning immune cells and reduce damage done to the joints.
Benefits
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Recent studies have shown that prednisone does more than provide symptomatic relief to people with rheumatoid arthritis. Bone and joint destruction appear to be significantly lessened in those who take low-dose prednisone, especially if it is started soon after the diagnosis of rheumatoid arthritis.
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Effects
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Unfortunately, prednisone is far from a miracle drug; doses high enough to treat rheumatoid arthritis without using other medications cause severe side effects, some of which can be permanent. Prednisone is associated with a wide range of side effects and adverse reactions including hyperglycemia (high blood sugar), weight gain, cardiovascular disease and a loss of bone density than can cause or contribute to the early development of osteoporosis. Prednisone can also cause emotional side effects, including depression and aggressiveness in some people.
Considerations
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Previously, prednisone was mostly used as a short-term treatment to relieve pain and swelling caused by an exacerbation (flare-up) of rheumatoid arthritis. However, because studies now show that the drug can lessen the damage caused to joints and bones by rheumatoid arthritis, it may be appropriate to take the medication for at least 2 years following diagnosis. Studies have not conclusively shown a benefit to beginning long-term therapy after the disease has been present for more than 2 years, however, nor do they show that continuing the drug for longer than 2 years is beneficial.
Warning
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Many doctors are reluctant to prescribe prednisone, and for good reason--the drug can cause a host of health problems that in some cases may outweigh its beneficial effects. However, if serious side effects do occur, prednisone cannot be stopped suddenly if it has been taken for a long period of time. The drug replaces cortisol produced by the adrenal glands, which eventually stop producing their own cortisol. As a result, you must taper off prednisone to allow the adrenal glands to begin producing cortisol again.
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