The safety profile of Actemra alone is probably better than prednisone alone. The difficulty is Actemra may not allow you to get off prednisone. You could wind up being on both prednisone and Actemra for a certain amount of time simply because prednisone can't be stopped abruptly.

Prednisone suppresses your immune system and increases your risk of infection. Actemra suppresses your immune system and increases the risk of infection. I had a tendency to get infections whenever I took prednisone in combination with any other medication that suppressed my immune system. My rheumatologist would say "too much immunosuppression" caused the infection instead of saying prednisone caused the infection or the other medication caused it. She said it was the combination of both medications.

Unfortunately, COPD increases your risk of a lung infection. I can understand your concern about adding Actemra to the mix. I don't know what you should do. Doctors face tough medical decisions all the time. That is why I never wanted to be a doctor.