How to Stop Prednisone Safely

Introduction to Steroid-Free Remission 0:00

If you have rheumatoid arthritis, chances are you were handed a prescription of prednisone and maybe you still might be holding on to it. Every time you try to taper down your predisone, you'll have a flare. This cycle is exhausting and it does not have to be this way. In this video, I'm going to break down exactly what it means to have steroid free remission and how you achieve it, please stick around. Hello all of you Rheumatoid Arthritis Warrior, this is Dr. Andhra Subedi, your rheumatoid arthritis coach at TheRoomDoc, as well as a practicing rheumeatologist here at Empower Arfitis.

Today I'm going to break down this complex concept of remission and how do we achieve remition without needing steroids. Before I go further, don't forget to like and subscribe to our video. Please add some comment in the comment below so that we can understand how you are handling steroids and how are you achieving steroid free remission in your RA treatment journey. Now, before we go farther, let's make this concept of remissions simple. And there are two important remittance concepts we need to understand.

One is clinical remition and other one is steroide free revision. Remission is a term we typically use when you have minimal symptoms or no symptoms of joint inflammation.

Clinical Remission vs Steroid-Free Remission 1:14

Clinical remission, is when, you don't have any joint pain, no stiffness, and you are totally functional with your joints. And the doctor will also check your blood markers, particularly two markers are typically used in understanding how your RA is doing, the sedimentation rate and C reactive protein. So for it to be clinical remision, your block marker has to normal. suggesting the inflammation is well controlled in your body. So this is what we call clinical remission. The next concept, the steroid free remition is the ultimate goal and this achieving and maintaining the clinical emission without you needing any corticosteroids or steroids.

and this is the gold standard for treatment for long-term health of rheumatoid arthritis. With the effective treatment we have available at this time and lifestyle changes, we can achieve these two types of remission, clinical remissions as well as a steroid free remition. And think of Remission as journey, not your destination. It requires a patient-doctor partnership. You need to work very closely with your rheumeatologist who will understand you, who'll listen to you and help you guide in this journey.

As I mentioned earlier, our goal, Our ultimate goal in treating RA is to achieve steroid free remission. And we use steroids as our short term tool. It's not a long term destination. Steroids are not the long-term solution because of all of those side effects that we have discussed in the prior videos. If you want to learn more about those Side effects, please refer to our earlier videos where I discussed extensively on short-term and long- term complication of side effects with the steroids. And our goal in RA treatment is getting you off of that steroid which your doctor might have started you in the beginning as a brisk therapy or during a flare.

Those are the two scenarios where I typically use steroids Number one, when you are initially diagnosed with the RA and we call that a bridge therapy that

Why Steroids Are Only a Short-Term Tool 3:08

will help you manage your symptoms quickly until those long-term medication kicks in and the second condition we use steroid is when we have flares. So any of those two scenarios, our goal is to use the steroids in the shortest possible and shortest duration of time. And to achieve the steroid-free remission, we typically use long-term medication. We call them disease-mortifying anti-rheumatic drugs that includes DMR as well as biologics. And they are our long term friend to help you control your RA.

Let me go back one more time. So steroids is a bridge. It's not a longterm destination. Always use steroids as your friend for a short period of time, not your long time friend. As we set our goal, the steroid free remission goal. There are four important strategies that we can use to help you get to that goal and the number one is early diagnosis. Starting treatment for your RA early is critical. It's critical for two reasons. One is achieving remissions early and also preventing long term joint damage.

And number two is, early use of disease modifying anti-rheumatic drugs and biologics. And these are powerful tools that help you control your inflammation, which is a primary problem in rheumatoid arthritis. So always work with your rheumeatologist to go on this DMAR and biologics early so that we can achieve disease in remission quicker and faster with less pain. Number three, having a good tapering protocol. If your doctor started you on steroids, either for a breast therapy or a flare, always have a game plan.

Always have a tapering protocol. Always ask your doctor, when can I come off of this steroid?

How DMARDs and Biologics Help You Taper 5:00

Always Have a clear taping plan. And number four, don't underestimate the importance of lifestyle changes. It is a game changer, along with your medications. Supporting your body with anti-inflammatory diet, exercise, managing stress is as important as taking your medication. So use lifestyle change as a prescription, not as substitute, but as complemented to your treatment. Even for helping you taper your steroid lifestyle changes are as important and the lifestyle things are also as Important to help you minimize the side effect of your steroids.

We have extensively discussed this in the prior videos. Please refer to those videos All of you rheumatoid arthritis warrior, I hope you are understanding more about how you can achieve disease remission without any steroids. If you like the video, please give us a thumbs up. Please add some comments so that we can understand how are you handling steroids and what's your game plan on coming off of your steroids? And also don't forget, we are coming up with a live question and answer session in mid-April where I'll be talking everything about steroids and I will be live.

And if you have any questions, please come up to those questions so that I can answer those. Let me highlight a little more on what is the role of DMAR and biologics in achieving steroid free remission. This medication we also call them steroid sparing agents, which basically means if you go on these DMAR and biologics, you may not need steroidal long drug. It's overall improve your chance of coming off of steroids. steroid which has many many side effects these medications DMAR and biologists are reasonably safer to be taken long term so they are safer option compared to long-term steroids and they also enable you to taper faster if your doctor combined bridge steroid therapy along with the DMR your chances of coming off of steroids is much much bigger.

You are able to come off a steroi faster without having any flare. If your doctor just do the prednisone there's a chance that as you taper your steroids you will go into a disease flare causing a lot of joint pain. So commanding them a Steroid as well as DMART is the best way for you to come off of steroids without causing disease flare. And by minimizing the steroid long-term use, you are protecting your health, your muscles, bone, and your other body, including your heart. That's why it's very important for you to be on DMART as a way of protecting your overall lung health without having side effects of the primary zone.

A pro tip, the DMART or biologics are the heavy lifter in managing your rheumatoid arthritis. They do the hard work so you don't need to rely on steroid long term. So let this heavy lifter do that job for your in Managing your Rheumataid Arthritis effectively without side effect.

Key Strategies for Achieving Remission 7:50

If you are on steroids, you might feel like you have a long journey on getting off of the prednisone, but you don't have to be feeling that way. With a good plan, You can have safe and painless journey of coming off the steroids. And here are three important things I highlighted. The number one is slow and steady wins the race. in your race towards remission, be patient and also work closely with your doctors, with a rheumatologist, so that they can help you gradually taper you off of the steroid and gradually increase the dose of your DMAR, which will help control your RA long term.

and also closely monitor your symptoms. Watch for any signs of flare and watch for signs for steroid withdrawal. And when you have those signs and symptoms, effectively and quickly communicate with your doctor so that they can understand and help you how to manage those problems. So work very closely under medical supervision with the rheumatologist, with primary care doctor, and with other healthcare team members so they help guide you in this journey. Now if in case when you are tapering your steroid if your symptoms comes back always communicate with your rheumatologist so that they can guide you how you can slow down your taper and they slowly escalate your demark therapy.

And monitor your progress, the progress of steroidal decrease as well as controlling your disease is as important. So having regular checkup with your doctors, with a rheumatologist give you the best chance possible to come off of steroid and controlling your disease and bringing it to revision. Your doctor will also do some blood work such as sedimentation rate and C reactive protein, which help us understand how your RA is doing. How is it control or not? It can also guide us on our taper plan for the steroi too.

So in this journey, you have a role. Your role is to closely track your symptoms and symptoms of disease flare that includes more joint pain, more stiffness or the symptoms off steroid withdrawal. So what's out for those symptoms? And document those. And effectively communicate with your rheumatologist so that they can understand what is a problem and they. Fix your problem. In a pro tip, if you can. Understand your. Symptoms early. You're rheumeatologists can manage those flare early, and do not wait for a major flare if you have any symptoms of early flare such as you are having

Monitoring Symptoms and Working With Your Doctor 10:20

more stiffness more joint pain alert your rheumatologist early so that they can intervene early without going to a measure flare which could sometimes be very painful. I hope all of you Rheumatoid Arthritis Warrior has a better plan on how you achieve clinical remission and steroid free remission, which is not having any RA symptoms without needing steroids. And in this journey, you have an important role. Your role is to closely monitor your symptoms, communicate with your doctors, and then understand better your health care symptoms so that you can effectively communicate.

and three important things to remember in this journey. 1. Steroid is the bridge is not the destination so use them during your flare and early on when you are initially diagnosed with rupitor arthritis. 2. Disease-modifying anti-rheumatic drug the DMARD and the biologics are your foundation in treating rp. And 3. Tapering must be slow and supervised under your rheumatologist or your primary care doctor. This will give you the best sense to come off of steroids without having the side effects. And a steroid free life is possible in RA, but it needs your partnership, it need your right plan and then right timing.

With all of these three important tools, you can achieve steroidal free remission and control your RA better. Thank you all of you rheumatoid arthritis warrior for watching this video. Please like and subscribe to our channel. Don't forget to put a comment below to tell us how your goal is, what your goals is to achieve steroid free remission and what are you doing to that goal. And also don't for get we are coming up with a live question and answer session mid-April where we will be coming with details soon.

I'll see you there. Bye bye.