enbrel and prednisone

** Originally posted by mommomt **

Hello to all! My name is Carol and i have been visiting this message board for almost a year so I feel like I know many of you already. It has helped so much to know that there are others like myself.I've been shy about posting (not good at typing)
but I really feel the need to talk to all of you .So here goes.
I've had pa for about 20 yrs. I'm 52 yrs.old. I've been using Enbrel for close to a year and it has helped.I'm also taking predisone and alot of other meds. This is where the problem is. My doc. was trying to get me off of predisone because of bone thinning problems,but every time we try my pa flares really bad.Does anyone else have to take prednisone w/ Enbrel? If so what are your feelings about the long term risks ? I wish I could stop the pred. ,but I can hardly function without it. Does anyone have an opinion about which one is worse prednisone or methotrexate? Any info would be greatly appreciated.

Report post

11 replies. Join the discussion

** Originally posted by EdR **

Hi Carol,

I'm sorry you're having such a difficult time getting off of prednisone. During your past attempts, would even a very gradually reduced dose still result in a flare? I don't have much experience with PA, but I have read that enbrel and methotrexate can be used successfully in combination therapy. There are several studies of rheumatoid arthritis showing that together enbrel and MTX are more potent than either one individually. Maybe you can use MTX to get off of the prednisone, then try tapering off of the MTX once your PA is under control?

Hopefully, someone with more experience or knowledge of psoriatic arthritis can add to this.

Best wishes,

EdR

Report post

** Originally posted by mommomt **

Thanks for the reply,Ed. I have tried very slowly to wean from the pred. but even the slightest change sets the pa crazy.I hated the thought of going on mtx because it sounds just as bad as pred. but you have just given me a great idea! I think I will ask my Rheumy to just try mxt just long enough to wean from the pred. and then stop . It's worth a try anyway.

Report post

** Originally posted by marianp **

Hi Carol,
I've been on MTX for about 1-1/2 years and Enbrel for almost 6 months. My rheumy had me reduce my MTX from 30 mg/week to 20 mg/week after I had been on Enbrel for 3 months. So I have been on the reduced MTX for 3 months. We are planning to continue reducing it if all goes well and eventually wean me completely off the MTX. So far my psoriasis continues to improve and my psoriatic arthritis has remained about the same with the MTX reduction. (This is after a very significant improvement in the PA after going on the Enbrel.)
I also take Celebrex--200 mg twice a day to help control the pain.
I have not had any problems with MTX (I take folic acid with it) except for the slight stomach ache when I initially went on it. I hope this information can be of some help to you.
Good Luck !!
Marian

Report post

** Originally posted by PJLeary **

Ok, that said, I know I am going to sound like a jerk.

How bad is the p/pa without the prednisone? How bad is the coming flare? I am sure these are not nice questions, but they are very much to the point, if you really want to be rid of the 'sone.

What %? 99%, 75%, 50%??

I have lots of experience recovering from that sort of flare, without oral steroids.

Ask me a question, and I will answer.

Report post

** Originally posted by Reeb **

PJ Leary, here's a question. I am new to dealing with PA and really don't want to get started on steroids(yet?), etc. How were you able to move through the flares without taking these meds? Are there any decent homeopathic remedies out there?

Report post

** Originally posted by web63 **

Are you on true Prednisone?
I switched to Medrol (Methyleprednislone).
This has help me.
Maybe mention it to your Rheumy.

Thanks,

Report post

** Originally posted by mommomt **

Thanks for the reply.I'm glad you found a combo of meds that works for you.I feel my best w/Enbrel and pred.,just really afraid of the long term effects.

Report post

** Originally posted by mommomt **

Hi PJ,
Thank you for your concern.My pa is pretty bad.It's in my spine,hips,wrists,handsand feet.My fingers are swollen and deformed.I can't make a fist anymore.so it's hard to hold on to things.I am never without pain but I refuse to give into it so I am always pushing myself harder and harder.I would say that the pain ranges from debilitating to just nagging.I take 2 celebrex,6 ultram,blood press. med.,anti-depress. pred.,enbrel,sleeping pill (pain in hip all night) and a few other unrelated pills!I try to hide my pain from everyone.My own family doesn't even know how bad it isBut I'm just getting so very tired of it.My p is not so bad.I have nail p and some on my spine and wrists.I guess we all have been through some of the same things.I think it really helps to hear how others have learned to cope.Any advice would be appreciated.
Carol

Report post

** Originally posted by mommomt **

Hi Scott
Thanks for your reply. I have read many of your posts so I know you have been through a pretty rough time and yet you take time to respond to others.Some really good people on this board!
I do take real prednisone.Didn"t know there was any other kind.Does Medrol work the same but with less side effects?How long have you been on it?
Carol

Report post

** Originally posted by PJLeary **

Hi Carol,

Your pa is the real big problem, not the p. Okay, I wonder if you have tried a 60 day taper yet? It would depend on the amount of 'sone you are taking, if you want to let me know here, I can make a non-medical suggestion. In some ways, your taper should be easier because you are looking at the potential of one flare and not two.

The good news about the enbrel is that it should arrest any further joint and bone damage. I support edr's suggestion that a short course of combination mtx may be a good choice for weaning off of the prednisone. Potentially you could be using just enbrel within 90 days with that plan and a long taper schedule.

Reeb:

I am sorry to report to you that I have moved through the pa flares very crippled and in a lot of pain for decades. Celebrex helped some, but I only used it prn when necessary to walk. Until I started the enbrel, there was never a solution that worked well for the pa.

However, that said, I can report a total recovery from my pa symptoms with the enbrel, almost immediately. The down side is that the information is still new, the long term info is yet to come. The thing that motivated me to try the enbrel was the possibility of arresting the joint and bone disease. I had hope a few years ago that a change of climate would be a big help, and it was, but it did not stop the progression of the disease.

I am still a young woman, and generally in good health other than the p & pa. Therefore, the biological medication is a very calculated risk, and one that I approached with caution. I am not one to rush to the next new wonder therapy because in my experience they do not work reliably for any period of time, and then I am often left worse off than when I started.

I wish I had better news for you.:rolleyes:

Report post

** Originally posted by mommomt **

Hi PJ,I have tried several times to do the 60 day wean from pred.I only taper 2.5 mg at a time.The pa flares eventually settle to a point that I can manage until I get to 1/2 tab(2.5mg) then it's unbearable.My Rheumy says she doesn't worry so much if she can keep me on no more than 5 mg. and that's where I am now.I just don't know which one would be worse ,to stay on that dose if my bones don't get any worse or to try mtx or maybe even that one that Scott said he is taking.Wow! Is all your pa pain really gone? Do you have much damage? I thought Enbrel was going to be my miracle drug but it's not working as well as in the beginning.It does help with morning stiffness and the red hot inflamation I get in my hands so I'm staying on that one.What are your days like? Do you have symptoms every day? Do you have trouble with weakening mussels from pa or meds? I do .I never know whether to push more exercise or let it rest.Do you know any good exercise programs for pa? Sorry to go on so.I have never talked so much about this and now that I have started I don't want to stop! Thank you so much for your concern.
Carol

Report post

This discussion is closed to replies. We close all discussions after 90 days.

If there's something you'd like to discuss, click below to start a new discussion.

Things you can do

Support the National Psoriasis Foundation

Help the National Psoriasis Foundation reach its goals and support people like yourself by making a donation today.

Donate to the National Psoriasis Foundation

Discussion topics

Additional resources

Community leaders