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@jfannarbor

I looked in PubMed and looked at all articles (63) that addressed prednisone AND low dose AND longterm and arthritis I didn't find the article I remember but I think he was the first author of the following article that addressed the subject we are looking at. The problem with finding the one I remember is many of the articles include other drugs to treat arthritis and the definition of "low dose" prednisone had changed over the years from < 15 to < 10 mg to now <5 mg. As I noted in my first post on this subject, I am on 2.5 mg of prednisone a day for over 5 years and it has helpe d me reduce the occurance of PMR. Below is the abstract of the article that I found and basically the authors noted in the last sentense of the abstract that low doeses OK but with brusing and thin skin as adverse effects. I have experienced this, but it is a minor problem. I should note that I am not your average patient since I am addicted to extensive exercise. Another interesting piece of information is the journal issue that the following abstract comes from had many articles on low dose prednisone to treat arthritis

CER5095
2011 Vol.29, N°5 ,Suppl.68
PI 0130, PF 0138
Paediatric Rheumatology

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PMID: 22018199 [PubMed]

Received: 15/09/2011
Accepted : 15/09/2011
In Press: 22/10/2011
Published: 22/10/2011
Abstract

This article summarises the experience of one academic rheumatologist in treatment of patients with rheumatoid arthritis (RA) over 25 years from 1980-2004 with low-dose prednisone, most with <5 mg/day over long periods. A database was available which included medications and multidimensional health assessment questionnaire (MDHAQ) scores for physical function, pain, and routine assessment of patient index data (RAPID3), completed by all patients at all visits in the infrastructure of care. Most patients were treated with long-term low-dose prednisone, often from the initial visit and indefinitely, and with methotrexate after 1990. The mean initial prednisone dose declined from 10.3 mg/day in 1980-1984 to 3.6 mg/day in 2000–2004. Although no formal criteria were used to determine the initial dose, prednisone doses were higher in patients who had more severe MDHAQ/RAPID3 scores, as expected, reflecting confounding by indication. Similar improvements were seen in clinical status over 12 months in patients treated with <5 vs. ≥5 mg/day prednisone, and maintained for >8 years. Adverse effects were primarily bruising and skin-thinning, with low levels of hypertension, diabetes, and cataracts, although this information was based only on self-report rather than systematic assessment by a health professional. These data reflect limitations of observational data. However, a consecutive patient database may provide long-term information not available from clinical trials. The data document that prednisone at doses <5 mg/day over long periods appears acceptable and effective for many patients with RA at this time. Further clinical trials and long-term observational studies are needed to develop optimal treatment strategies for patients with RA with low-dose prednisone.

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Replies to "I looked in PubMed and looked at all articles (63) that addressed prednisone AND low dose..."

I just ran across another a randomized controlled clinical trial on low-dose prednisone. In this case, it was 10 mg for two years. The problems seen by the prednisone group do not seem bad at all. It noted that prednisone helps osteoarthritis, especially in the first 6 months. The reference is: Low-Dose Prednisone Therapy for patients with Early Active Rheumatoid arthritis: Clinical Efficacy, Disease-Modifying Properties, and side effects Ann Intern Med 2002; 136:1-12