Prednisone is a corticosteroid. Corticosteroids are also called glucocorticoids. Glucocorticoids are drugs that have been chemically synthesized to resemble naturally occurring steroid hormones produced by the adrenal glands. These steroid hormones are responsible for regulating various metabolic functions in the body.
Prednisone is a powerful anti-inflammatory drug used to treat various inflammatory disorders. It is particularly used for treating different forms of arthritis such as sytemic lupus erythematosus, rheumatoid arthritis, and polymyalgia rheumatica.
In rheumatoid arthritis, it is extremely effective and is often used early in the course of disease as a bridge to help a patient feel better before more long-acting medicines have a chance to work.
The use of prednisone is controversial. However, literature data, as well as the collective experience of numerous clinicians has suggested that prednisone, when used by a skilled rheumatologist, is an excellent tool.
Like many medicines that have proven benefits, glucocorticoids also have potential side effects. These include:
Increased risk of cardiovascular disease
Development of a buffalo hump
Insufficiency fractures due to osteoporosis
Increased risk of infection
Avascular necrosis (dead bone)
Depression and psychosis
Thinning of the skin
Striping of the skin (stria)
Excessive hair growth
Adrenal gland suppression
Steroid withdrawal syndrome if discontinued abruptly
The word potential should be stressed with side effects since the majority of patients who are treated with low dose prednisone do not develop these problems. As with all drugs, risks and benefits must be weighed.
The lowest possible dose should be used. Once the rheumatoid arthritis has gone into remission, attempts to taper the prednisone should be instituted. Careful monitoring of potential side effects should be performed regularly.
In patients with severe rheumatoid arthritis, the use of prednisone in low doses may be advisable. Use of high doses of steroid drugs over an extended period of time should be avoided. Consultation with a knowledgeable expert in rheumatology is advised.