How many pred cures have you done?

jeanloup

Regular Member

Joined : Apr 2014

Posts : 178

Posted 5/13/2014 4:29 PM (GMT -6)

Hi,

Here in France doctors say if you do 2 cures of pred it's a sign you are becoming cortico-dependant and you have to switch to another treatment like imuran for instance, and stop using pred.

I read some people use pred each time they flare, no matter if it's the 2nd or 3rd or 10th time...

So where is the just middle?

garylouisville

Veteran Member

Joined : Aug 2012

Posts : 9088

Posted 5/13/2014 5:58 PM (GMT -6)

Pred has it's uses but if you are on it for months year after year after year that is too much. Pred never "cures" anyone. All it does in some people is help bring on a remission but in the vast majority of those people the remission will not stick once tapered off, thus the use of maintenance meds. You take both pred and the maintenance med, taper off the pred, and hopefully the maintenance med will keep you in remission. If it doesn't then you need to switch to a new maintenance med and hopefully when the pred is tapered off again the new maintenance med will keep you in remission. Pred will very rarely keep anyone in remission once tapered off with no maintenance med. It only works while you are on it and not when tapered off. My GI won't even usually prescribe prednisone because he knows it won't put anyone in remission by itself. I had to ask him for a course to attempt remission. It didn't give me one once tapered off, even while on a maintenance med.

Pentasa(500mg) 2 pillsX2; VSL 1 pillX2; Prescrip Assist Probiotic 1 pill X 2;Vitamin D3;Grape seed extract 400mg X 2; Canasa as needed; DAO as needed due to dietary histamine intolerance

Gave me trouble: Robinul; Zymactive, Renew Life Probiotic 80 billion, Florastor

Post Edited (garylouisville) : 5/13/2014 6:23:25 PM (GMT-6)

NiceCupOfTea

Elite Member

Joined : Jan 2010

Posts : 10751

Posted 5/13/2014 6:13 PM (GMT -6)

I think 'cures' is meant to be 'courses'.

I'm totally with the French doctors on this one. To be fair, there should be some sort of time limit placed: I think after 20 years you can have a 3rd course of Pred for example. But if you're needing a course of Pred every 1-2 years, it ain't working: it just ain't working. #foundthisoutthehardway

PS: To answer the question, I lost count at some point but I reckon at least 10 courses in the space of about 8 years. For the last year and a half before surgery, I was on Pred almost continuously. Must have crammed in about 5 courses' worth in that time alone. On 40mg Pred I was in "remission", but the moment I tapered symptoms began to return. Eventually had to have my colon removed, it was that bad.

~
Dx Crohn's in summer of 2000.
Tried and failed: 5-ASAs, Azathioprine, 6MP, Remicade, Methotrexate, Humira.
Diet didn't make any difference either.
The only med which worked was Prednisolone, so I ended up steroid-dependent.

Had surgery 2/13 - subtotal colectomy with end ileostomy. Currently on no meds and in remission. Also prone to depression and anxiety. Ask me anything >_>

Post Edited (NiceCupOfTea) : 5/13/2014 6:23:11 PM (GMT-6)

aguywithuc

Veteran Member

Joined : Jun 2010

Posts : 3014

Posted 5/13/2014 6:22 PM (GMT -6)

Yeah heard same nonsense. New GI ordered imuran or whatever even after I told her NO.

She must be shocked I am still alive.

nightside of eden

Veteran Member

Joined : Sep 2009

Posts : 552

Posted 5/13/2014 6:28 PM (GMT -6)

I've had 10-15 in ten years

32 yr old Male
Diagnosed when I was 15
8 sulfasalizine a day
50 mg of Prednisone
Klonopin

jeanloup

Regular Member

Joined : Apr 2014

Posts : 178

Posted 5/14/2014 11:07 AM (GMT -6)

Yes I meant courses, sorry :)

I am in my 3rd course, this time it wasn't very effective, and anyway it is quite useless if flares are coming back a few days after we stop pred. My maintenance med isn't very effective neither (5asa).

Let's try some natural treatments before firing up imuran...

I'm trying VSL right now.

Post Edited (jeanloup) : 5/14/2014 5:10:49 PM (GMT-6)

deltaforce

Veteran Member

Joined : Jun 2010

Posts : 2280

Posted 5/14/2014 5:50 PM (GMT -6)

Almost 10 in last 8 years, and I disagree with that opinion.

There are a LOT of factors on what puts you in flare. Unless you are meticulous to find out the triggers and trying to avoiding those you would not know. That said, not necessary that you will find a trigger every time. Personally speaking, Out of all my flares, I don't know triggers of 2 of those.

What dose Pred should be started, thats another topic of discussion. Some GIs prefer to keep low where as other give you a canon. Although both styles are good, I would prefer higher dosage only because if you keep taking low dose, the response that you get in return is underwhelming and in long run you may end up using good amount of Pred with little effect.

And don't be scared of Imuran. If it is stepped up slowly with liver function before every step up, you should be safe. Its one of the best drugs I used for 6 years.

Dx 03/2007, left sided UC.
Sulfasalazine 1.5gm, Vit. B12, 1mg, Multivitamin, 1 tablet, Fish oil 2400mg , Butyrate 2-3 caps, Vit D 2000 IU, Benebiotics 2caps, Folic acid 1mg. Canasa

Verapamil 320mg for migraine,
Nabumetone 750mg as an abortive, so far so good with GI side effects.
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