Steroid treatment for RA and advice for tapering

We know that steroids are an important component of the management of rheumatoid arthritis. For people with RA, steroids are primarily used as an add-on therapy to disease-modifying treatments, such as disease-modifying anti-rheumatic drugs (DMARDs), including newer biologic treatments. Steroids are strong anti-inflammatory drugs that can be used to provide rapid control of disease activity such as inflammation, but are not intended for long-term use. One of our community members who is taking the DMARD, Placquenil, asked for advice on stopping her adjunctive steroid treatment.

Community question:Do you have any advice on weaning off of prednisone? I started Placquenil treatment 7 weeks ago, and my doctor wants me to stop taking prednisone. I’ve been taking it in the morning and in the evening. I reduced my evening dose from 5mg to 2.5mg. Unfortunately, my nausea and loss of appetite have gotten worse, and I’ve had an overall increase in moodiness. It’s awful. I think I need to slow down the taper. Thank you for any advice. Also - doesn't it take a long time for placquinil to work?

Response from our moderator, Andrew Lumpe:
It's a good idea to not use prednisone long term. Withdrawl can take a while as your body stops making cortisols when on it and it has to get back into the swing of things. You really should talk to your doctor about your tapering schedule and any side effects you're experiencing. They may want you to slow down. Plaquenil can take up 1-2 months to start working and up to six months for full effect. More information for Plaquenil can be found here.

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