Welcome to the forum but sorry to hear you are flaring severely!
Certainly, ask for the maximum flare-dose of your oral mesalamine lialda/pentasa/asacol (often 4,800-mgs a day but varies with some formulations so ask your doctor/pharmacist about
your brand's max), and also a 4,000-mgs a day of rectal-route mesalamine retention-enema (aka rowasa/pentasa/salofalk enema). That is in addition to your Prednisone.
What prednisone dosage where you given, 40-mgs a day or more I hope?
How bad are your symptoms (# of bms a day, urgency, blood, pains, etc.)?
With UC there are three classes of medications:
- First is anti-inflammatory mesalamines (max dosages described above). If that's not enough then you need to escalate up the medication ladder.
- Second and third classes of UC medications are immunosuppression using different methods.
- Second class is thiopurines (azathiopurine/imuran/6-mercacaptopurine) which are simple oral pills you swallow, take 3-months to work, and require blood monitoring for as long as you are on these meds. White Blood Cells (WBCs) skyrocket during our flares, WBCs directly cause inflammation, and these medications slow the rate in which our body can create new WBCs. The less WBCs we have, the less inflammation we can have, and the better we feel. The ongoing blood monitoring (every 3-months for as long as you are on these meds) ensures your WBC count does not suddenly get too low, as you need WBC to fight off common infections.
- Third class of UC meds is biologics (humira/remicade/entyvio) which are small blood-borne proteins that interfere with the immune system's ability to request, respond, or complete an immune attack. Remicade muffles/mutes the immune system's call for an attack. When the battle-cry is silenced, WBCs do not attack and no inflammation is caused, and we feel better.
I understand that many of us are initially concerned (maybe even scared spitless) when first reading about
the potential side effects of biologics. An important thing to understand, is the actual risks versus benefits of these treatments. Can these meds cause a cancer? Yes. How often? about
2 in 10,000 (0.02%) healthy people without any daily medications get a lymphoma. Those taking biologics have a 4 in 10,000 (or 0.04%) odds of getting a lymphoma. What happens to those who get the lymphoma? 66% are able to put that into a remission and it is not a problem going forward. So there is a rare risk of a serious side effect that is certainly important to be aware of. However, the odds are nothing to loose any sleep over. The benefits far outweight the risks.
A good deeper dive into risks versus benefits, here's a good read from the CCFA:
I've been on remicade 7+ years, I've had zero side effects, and I am not any more sick than my normal. I achieved and sustained my first remission thanks to remicade, it has been a total game changer for me. Only a few infrequent and mild flares since.