@grumpa

For the time we need both Prednisone and a biologic like Kevzara we have a higher risk of infections. Both Prednisone and biologics suppress the immune system. I was prone to infections when I took Prednisone in combination of any other conventional DMARD or biologic DMARD. My rheumatologist believed that Prednisone alone was bad enough because of immunosuppression but seemed to think 3 mg or less wasn't so bad.

Whenever I had an infection while on Prednisone in combination with something else, my rheumtologist blamed it in too much immunosuppession compared to saying either Prednisone or the other medication caused the infection.

Prednisone alone increases the risk of diverticulitis. Prednisone in combination with Kevzara compounds that risk. Were you ever able to stop Prednisone when you were taking Kevzara???

I had some problems with low neutrophils when I first started Actemra along with Prednisone. My rheumatologist delayed a few doses of Actemra until my neutrophils improved. Apparently the absolute neutrophil count is more important than the percentage count. While a complete blood count (CBC) with a differential shows both total white blood cells and the percentage of each type, the absolute number is more clinically useful.

Absolute neutrophil count (ANC) is the actual number of neutrophils per microliter of blood and gives a truer picture of your immune system's ability to fight off infections.

After I was able to taper off Prednisone and treated with Actemra alone--my blood counts normalized. I don't seem to get many infections anymore.

As for diverticulitis ... I was very worried about that. My rheumatologist screened me for diverticulitis before starting Actemra. The "screening" amounted to asking me if I ever had any bowel problems while I was on Prednisone. I denied having any problems but I took omeprazole for years while I was on prednisone to "protect" my gut.

A few months ago I had a colonoscopy. I was very relieved that only a small polyp was found but no diverticulosis or evidence of diverticulitis was found after 6 years of being on Actemra. I stopped taking omeprazole shortly after Prednisone was stopped.

Actemra (tocilizumab) increases the risk of diverticulitis, the infection of diverticula, but does not cause the underlying condition of diverticulosis, which is the formation of the pouches themselves. I assume Kevzara is the same.