Prednisone and new research findings from Canada

As a synthetic corticosteroid drug, there's a very strong effect on the body's immune system. The problem when prescribing this drug is to strike a balance between its effectiveness in reducing inflammation and the reduction of resistance to infections. This problem is not restricted to particular inflammatory conditions. It's an inherent danger arising from the way in which the drug affects the adrenal gland. So, if you have asthma and take any of the inhaled corticosteroids over any significant period of time, you can expect an increased number of both viral and bacterial infections affecting the respiratory tract. The latest research from Canada has been looking at the health of seniors whose autoimmune system is often working less efficiently, exposing them to higher risks of infections.

About 5% of seniors have rheumatoid arthritis and doctors around the world turn to the corticosteroids as a first line of defense. The difficulty is that the treatment undermines the already weakened immune system making it more likely the seniors will fall prey to pneumonia and other serious illnesses warranting hospital treatment. The research carried out by McGill University compared seniors who were admitted to hospital with serous infections. The patients were divided into two groups. The first was admitted to hospital with no prior diagnosis of serious heath problems and no current drug regimen. The second had already been diagnosed with a serious problem such as rheumatoid arthritis, lung and kidney diseases. These patients were already taking drugs to control their problems.

The study shows that people already diagnosed with chronic health problems were significantly more likely to be hospitalized with infections. Within that group, the individuals most likely to be affected were already taking drugs that reduced or suppressed the immune system. The researchers therefore suggest that the first response to those diagnosed with chronic health problems should not be the use of drugs affecting the immune system. It should not perhaps be surprising that Prednisone was found to be the biggest offender in this respect. Of all the drugs taken by patients, this had the most dramatic effect in increasing the risk of infections. The very precise recommendation is that if the use of an immunosuppressant is unavoidable, it should only be prescribed at the lowest possible dose to give some relief and for the shortest possible time. This treatment should be paralleled by vaccinating against all the current strains of the flu and, wherever possible, against pneumonia which proved to be the biggest killer in the group of patients studied. If seniors are not treated as an at-risk group and given all necessary preventive treatments, they are likely to end up in hospital and many will die. This is not to say the immunosuppressants are inherently dangerous and should be avoided. But it does mean that everyone offered Prednisone should understand the risks and use it only when absolutely necessary.

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