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Is Increasing Dosage Of Prednisone And Methotrexate Advisable For The Management Of RA?
Question: I developed severe RA ten months ago. Prednistone and methotrexate fixed it!Reduced Prednistone dose and went backwards. Increased dose to original and added Plaquinal. Came good again, reduced Prednistone and want backwards again. Increased dose again and came good. Reduced Prednistone a few weeks ago and went backwards again. Increased dose and coming good again but now on Humira also. Now they also suggesting Exeljanz as an additional treatment shortly. How do we have any idea what works and why do we put all these additions in when original Prednistone and Methotrxate work so well with no side effects? I'm 76 y.o. Thanks for your help. Regards, XXXX
Brief Answer:
Management of Rheumatoid
Detailed Answer:
Good evening
Thank you for writing on health care magic
Well, in Rheumatoid we normally dont use steroids at a high dose for long causing it starts causing bone weakening( Osteoporosis), cataracts, rise in blood pressure and blood sugars. Especially at your age, if these new side effects come up it will get difficult to manage everything together. So the first aim is to cut down on steroids to the minimum possible dose.
Secondly, I see you are on Biological drugs. I would like to know what was the maximum dose of FOlitrax which you are on?
Thirdly instead of Exeljanz I would have preferred a combination of leflunomide, methotrexate and maybe lowest dose of prednisolone( 2-3 mg) for optimizing control.
It is difficult to predict which drug will work in which individual as everyones genetics are different. Some people respond to single drug and some dont respond to 4 drugs also. So mostly it is a trial and error amongst the best choices available.
But yes, no no to the dose of prednisolone more than 5 mg at your age and that also in Rheumatoid when better drugs are available to control it.
Hope the information was useful
Do let me know for more queries
Regards
Dr Naval
Management of Rheumatoid
Detailed Answer:
Good evening
Thank you for writing on health care magic
Well, in Rheumatoid we normally dont use steroids at a high dose for long causing it starts causing bone weakening( Osteoporosis), cataracts, rise in blood pressure and blood sugars. Especially at your age, if these new side effects come up it will get difficult to manage everything together. So the first aim is to cut down on steroids to the minimum possible dose.
Secondly, I see you are on Biological drugs. I would like to know what was the maximum dose of FOlitrax which you are on?
Thirdly instead of Exeljanz I would have preferred a combination of leflunomide, methotrexate and maybe lowest dose of prednisolone( 2-3 mg) for optimizing control.
It is difficult to predict which drug will work in which individual as everyones genetics are different. Some people respond to single drug and some dont respond to 4 drugs also. So mostly it is a trial and error amongst the best choices available.
But yes, no no to the dose of prednisolone more than 5 mg at your age and that also in Rheumatoid when better drugs are available to control it.
Hope the information was useful
Do let me know for more queries
Regards
Dr Naval
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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