Prednisone for Psoriatic Arthritis: Dosage and Benefits


Psoriatic arthritis (PsA) is an inflammatory form of arthritis that occurs when the immune system mistakenly attacks healthy tissue in the joints. These attacks trigger inflammation, which leads to joint pain, swelling, and stiffness.

Prednisone is a type of corticosteroid that helps reduce systemic inflammation. Doctors may prescribe prednisone in combination with other treatments to help relieve the symptoms of RP and control the progression of the disease.

This article describes what prednisone is and how it can help with PsA. It also provides information on how doctors prescribe prednisone and the possible side effects of this medicine.

Prednisone belongs to a class of drugs called corticosteroids. These anti-inflammatory drugs are synthetic versions of hormones produced by the adrenal glands.

Doctors may prescribe corticosteroids to help suppress the immune system or relieve swelling and inflammation. Certain conditions that corticosteroids can help treat understand:

Prednisone is available under the following brand names:

Each of these drugs is available as an immediate-release tablet, a delayed-release tablet, or a liquid solution.

PsA is an autoimmune disease in which the body’s immune system mistakenly attacks healthy tissue, causing inflammation. In RP, this inflammation triggers joint pain, swelling, and stiffness, and can also cause a rash. Over time, this systemic inflammation can lead to permanent damage to joints and tissues.

A doctor may prescribe prednisone to help suppress the overactive immune system and reduce the production of chemicals that trigger inflammation. In this way, the drug helps relieve joint pain, swelling and stiffness.

One older 2013 case study suggested that early treatment for RP with a combination of corticosteroids and disease-modifying anti-rheumatic drugs (DMARDs) may improve outcomes for people with RP. Concretely, it can have the following advantages:

  • control early joint inflammation
  • prevent joint damage
  • maintain long-term functional capacity and quality of life

People who take prednisone usually take it by mouth, in tablet form. Doctors recommend taking prednisone in the morning because it is very similar to the natural hormone cortisol, which is at its peak early in the day.

The severity of a person’s symptoms and their individual treatment goals will determine how much prednisone they should take. The optimal dosage will also depend on whether the person has other underlying conditions.

According to Arthritis Foundation, people who have liver scarring, called cirrhosis, or an underactive thyroid, known as hypothyroidism, may need a lower dose.

As a general rule, the starting dose of oral prednisone is 5 to 60 milligrams (mg) per day. A doctor may adjust or maintain the daily dose until they are satisfied that PsA is well controlled. They will then gradually reduce the daily dose in small increments to establish the lowest dose needed to effectively manage the disease.

The authors of a 2013 case study reported that a combination of ARMM and low dose prednisone every other day significantly improved severe symptoms of RP in an individual within one week. Decreasing the initial prednisone dose from 10 mg to 2.5 mg every other day helped control the disease in the longer term. This, in turn, helped prevent joint damage and improve a person’s quality of life.

If a person needs long-term treatment, their doctor may prescribe prednisone every other day. However, doctors may recommend daily treatment with prednisone during PsA flares.

If a person needs to stop taking prednisone, their doctor will gradually decrease the dose to prevent withdrawal symptoms.

The higher the dose of prednisone and the longer a person takes it, the greater the risk of unwanted side effects. A lower dose of prednisone by 20 mg or less daily is associated with a decreased risk of side effects.

However, not everyone who takes prednisone will experience side effects. When side effects do occur, they usually go away as the dose decreases or treatment is stopped.

Common side effects of prednisone include:

According to Arthritis Foundation and the Canadian Arthritis SocietyYes, prednisone can also cause the following side effects:

People can take steps to reduce the risk of certain side effects while taking prednisone. These steps include:

  • eat a nutritious diet and exercise regularly to avoid weight gain
  • taking the medicine with food or milk to compensate for feelings of nausea or indigestion
  • taking the medicine in the morning to help reduce the risk of insomnia

Can prednisone make PsA worse?

At the time of writing, there is no recent reliable evidence to suggest that taking prednisone or any other corticosteroid can make RP worse.

Prednisone can interact with other drugs, supplements, or herbal remedies. These interactions can be harmful or affect the effectiveness of the medicine.

People taking any of the following medicines should consult their doctor before taking prednisone:

People who take prednisone should also avoid live vaccines because prednisone can weaken the immune system.

Learn more about drugs that may interact with prednisolone.

A person taking prednisone should call their doctor right away if they have any of the following symptoms:

  • Symptoms of an infection:
  • Symptoms of hyperglycemia:
    • drowsiness or confusion
    • thirst or excessive hunger
    • urinate more often than usual
    • rapid breathing
    • fruity breath
  • Symptoms of Cushing’s syndrome:
    • weight gain in the upper back or stomach
    • puffy face
    • severe headache
    • slow wound healing
  • Symptoms of adrenal gland problems:
    • weightloss
    • nausea
    • vomiting
    • dizziness
    • muscular weakness
    • tired
    • mood swings
  • Symptoms of low potassium:
    • muscle pain or weakness
    • cramps
    • abnormal heart rhythm
  • Symptoms of pancreatic problems:

A person should see a doctor immediately if they experience one of the following while taking prednisone:

Rarely, prednisone can trigger a serious allergic reaction called anaphylaxis. People who have any of the following symptoms of anaphylaxis will need urgent medical attention:

  • breathing or speech problems
  • swelling of the face, lips or throat
  • rapid heartbeat
  • dizziness or fainting

Prednisone is a corticosteroid drug that helps suppress an over-reactive immune system and control inflammation. Doctors can prescribe prednisone to treat a range of autoimmune and inflammatory conditions, including psoriatic arthritis.

In combination with first-line treatments for RP, prednisone can help control joint pain and inflammation and prevent permanent joint damage. Due to these effects, it can ultimately help improve a person’s quality of life.

Prednisone has the potential to cause side effects. Anyone who experiences side effects should see a doctor as soon as possible to avoid complications.

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