the long term health effects of pred are almost gauranteed. those with serious biologic side effects are just a few percent.
In a nutshell this. It also tends to be elderly people with multiple health conditions who get serious infections from the biologics. (And 90% of the exeptions to the rule find their way towards HW.)
But the long-term side-effects of Pred are 100% guaranteed, no matter your age or health status. The only requirement is being on Pred for long enough to get them. For some people it'll take weeks, others months or years. But it will