Steroids versus biologics

I have had UC for over 30 years, and have been off and on prednisone with no visible side effects. Usually would take 30 or 40 mg daily and taper down to none once flare under control, which was probably 15 times approx thru the years. I had been on 5mg daily for over a year from last flare up, new doctor very much against the steroid. I have been in relapse of some sort for most of the year, she did allow prednisone twice this year, now wants to try biologic approach. From what I am reading, Humira and Remicade are nowhere near fail-safe, as my prednosine was. I am 53, prednisone always worked for me, now it seems everyone wants to go biologic. Anyone else out there been on prednisone and having relapse without it and finding no one wants to prescribe it?? Being on the Lialda and azathioprine is not enough for me to stay out of relapse, apparently.

(I added a subject)

Post Edited By Moderator (iPoop) : 11/6/2016 8:06:33 AM (GMT-7)

It sounds like you had a course of steroids once every 2 years on average. Not ideal, but probably not all that dangerous provided you weren't on any steroids between courses. I was able to take a course of pred once a year (on average) for a few years without any apparent side-effects.

You can see the problem already, can't you? You are no longer able to keep going for a while without any steroids, but are on 5mg for maintenance. That will creep up to 10mg, then 15mg and so on, until you are hopelessly steroid dependent. That's when the side-effects kick in. That's when steroid withdrawal symptoms becomes hell. (Yes, I'm speaking from personal experience.)

In a nutshell, your new doctor has the right approach. Go on a biologic and try to kick the pred.

Welcome. Steroids are one of the most effective ulcerative colitis medications but unfortunately one of the short term only, rescue medications as they do irreversible damage to your body over longterm use, and also cumulative short term use over many decades. Your uc isn't well controlled if you need steroids that often.

I'd go biologics. It's true about 65 percent of uc patients respond to biologics, so nothing's a guarantee. Can't hurt to try, the odds are at least in your favor. Biologics are the only uc medication to put my uc in remission.

The bad long lasting side-effects are unseeable. I am suffering from the effects of long-term steroids, I have osteonecrosis of my right hip and need to have a total hip replacement; basically the steroids killed my hip.

I also had my skin thinned out from the prednisone, when I went for my laparoscopic colectomy my skin failed due to the steroid use. They then had to switch from Laparoscopic to an open surgery and have a 12" scar on my stomach from it.

Biologicals are well studied and very safe for most people.

I wonder what your bone density is.

I have had better results with Humira than Prednisone ever did. Humira put my crohn's colitis and RV fistula into remission, prednisone, IMO is the type of "band aid" treatment that doesn't "stick" compared to biologics based on my experiences.

Apparently in Canada where I live, less and less GI's are even considering Prednisone anymore because they say that biologic's have a much better affect overall.

jujub said...
Sometimes steroid side effects aren't at all visible until they are. Then you have a completely collapsed head on your femur or humerus, likely with intense pain.

Osteonecrosis freaking hurts, I've been dealing with off and on for the last 2 years and now it's getting really bad. I'm getting it fixed next month but I'm not looking forward to it, I won't be able to drive for upto 8 weeks because it is my right leg that I'm having surgery on.