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Crohn's Disease Forum » Treatment » Prednisone OR biologic??


07-18-2017, 06:19 PM   #1
abc4765
 
Join Date: Jul 2017
Prednisone OR biologic??

I was diagnosed with Crohn's a year ago. I initially went on 30 mg of prednisone and felt great minus the prednisone side effects and 20 pound weight gain. I began a mild flare in May which is progressively causing me more pain. I tried 15 mg of prednisone which did not help, but I really didn't feel comfortable taking it again. My dr said I can either up my prednisone or start on a biologic. The side effects of the biologic also concern me such as the increased risk of cancer and infection. I'm not sure what would be safer at this point- prednisone or biologic?? Anybody have any advice on what to do? I'm a 33 year old teacher and any flare up makes it difficult for me to work considering I can't just leave a classroom full of students to use the restroom. I appreciate any advice!
07-18-2017, 06:55 PM   #2
my little penguin
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Join Date: Apr 2012

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Prednisone is short term rescue med
It can't be used longer
If you do use it multiple years in a row -then side effects are extremely common
Glaucoma
Osteoporosis
Bleeding
Cateracts
Diabetes
Adrenal insufficiency

Ds has had to use steroids as a rescue drug (3-4 months at a time )
On and off for a few years
Due to this he now needs to be followed by endocrinology
For possible adrenal insufficiency
Watch for times his body is stressed (infections cold etc...)
Which requires a stres dose of steriods to protect his body

Every time you take steriods your adrenal gland goes to sleep
The longer it sleeps the harder it is to wake it up and get it to function properly even when it does

Ds has been on humira plus mtx for over 5 years
(Steriods were used when he had to stop biologics for other reasons not Crohns )

Understand undertreated Crohns allows the body to continue the inflammation cycle
Over and over
This cause cell changes and scar tissue
The scar tissue thickens and becomes rigid this means higher risk of obstruction and fistulas
Cell changes increase risk of cancer

Ds was dx at age 7
So almost 7 years ago
And has been on biologics since age 8

No extea colds or infections despite going through all the lower elementary grades and middle school

Not every drug is gor everyone
But finding a maintenance meds that keeps things calm is key

Tagging Maya142

Good luck
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DS - -Crohn's -Stelara
07-18-2017, 07:39 PM   #3
Maya142
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I would definitely use biologics over Prednisone. My daughter has been on biologics for years without issues. Unfortunately, she has severe inflammatory arthritis that has been very hard to control even with biologics and immunomodulators and so has been on Prednisone a lot.

She is now paying the price - she has developed low bone density (which is likely a combination of steroid use and of inflammatory arthritis), Cushing's Syndrome and now Adrenal Insufficiency. Essentially, her adrenal glands have stopped functioning because her body is so used to getting steroids from an outside source (Prednisone/Medrol/Entocort). This can cause LOTS of problems and can even cause an adrenal crisis - which in the worst case, could be fatal.

You also really need a treatment that will prevent the progression of Crohn's - so you can avoid complications like abscesses, strictures, fistulae etc. Untreated inflammation is very harmful and steroids are not really a good long-term option because of all the awful side effects that come with them.

We also worried a lot about putting my daughter on biologics, but at some point, the disease became scarier than the medications. Here is a good presentation which illustrates the risks and the benefits of IBD medications: http://programs.rmei.com/CCFA139VL/

Good luck!
__________________
Mom of M (20)
diagnosed with Crohn's Disease at 16
Juvenile Idiopathic Arthritis at 12
Juvenile Ankylosing Spondylitis at 16

Mom of S (23)
dx with JIA at 14
Ankylosing Spondylitis at 18
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