Comment By the founder of Dragon Claw. A Personal View
Michael Gill

I am of the view that Prednisone, as a drug for people with RA, may be useful for the very short term but has very serious negative side effects from thinning skin, damaged eyes and organs to bone loss. I also contend that many doctors prescribe the drug up to 40 mg per day when the recommended dose is 20 mg. The drug is cheap to make so there is little incentive to make something safer.

In the Journal Rheumatic & Musculoskeletal Diseases of April 2019 there is an article about the early results of a trial drug called Fosdagrocorat (code named PF-04171327) based on 323 patients. It seems that the drug was more effective than Prednisone but had a similar long term negative impact on the patient. To quote the abstract - "All fosdagrocorat doses reduced glycosylated haemoglobin levels. [Adverse events] AEs were similar between groups; 63 (19.5%) patients reported treatment-related AEs; 9 (2.8%) patients reported serious AEs. No patients had adrenal insufficiency, treatment-related significant infections or laboratory abnormalities. No deaths were reported."

While the reported study was not written for patients and is very technical, it was executed over a 13 week period. In my view such a short period tends to underplay adverse events, especially long term ones. The researchers indicate that the trial drug at 10mg or 25mg per day had the same clinical efficacy as prednisone at doses greater than 10mg per day.  The article seems to suggest that the trial drug is a useful replacement for prednisone but more research is required.  With a similar adverse event profile as prednisone, why bother!  It is about time, researchers, pharmaceutical companies and governments get together and fund a 'common good' search for a replacement medication to prednisone.  I suggest that the cost-benefit, if measured to include treating the horrendous side effects up to five years from disease onset, would convincingly suggest that the initial investment is worthwhile.  Well meaning pharmaceutical company seem unable to fund such research so patients need to apply pressure as a group.