Prednisone is a medication that is used to treat many different inflammatory conditions, such as rheumatoid arthritis, lupus, inflammatory bowel disease, allergic reactions, and scleroderma. It is available as a cream, oral tablets, or an injection directly into the bloodstream.
How prednisone works
Prednisone is a synthetic corticosteroid. A similar compound is made naturally by the body, and works to reduce inflammation by suppressing the immune system.
Prednisone is a treatment option for both localized and systemic forms of scleroderma, as both types are characterized by an overactive immune response. In localized scleroderma, steroid creams may be used for patches of superficial skin symptoms, while oral prednisone may be used for more extensive disease.
Patients with systemic scleroderma who are treated with oral prednisone have a higher risk of developing scleroderma renal crisis. Current guidelines include oral steroids as a treatment option for those with systemic scleroderma, but recommend close monitoring of kidney function.
Prednisone studies for scleroderma
Despite prednisone being a commonly used medication for treating scleroderma, the evidence supporting its use to treat this condition is limited.
A systemic review published in 2013 looking into all studies on corticosteroid use in systemic scleroderma revealed mixed results in terms of the medication’s ability to treat lung scarring (also known as interstitial lung disease) and skin symptoms.
It is important that prednisone is taken consistently, as suddenly stopping any steroid medication can trigger a serious condition known as an adrenal crisis. This condition is marked by an inability of the adrenal glands to produce necessary hormones. This is especially important if prednisone has been taken for more than two weeks.
When the decision to stop prednisone is made, a patient would usually be placed on a steroid taper regimen, where smaller and smaller doses of the medication are taken before it is stopped completely. Stopping prednisone in this manner is safer and reduces the risk of adverse effects.
Common prednisone side effects include sleeping problems, mood changes, increased appetite, weight gain and changes in the shape or location of body fat, acne, increased sweating, dry skin, bruising or skin discoloration, slower wound healing, headache, nausea, stomach pain, and bloating.
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