Cortisone and its derivatives are steroids, the most effective anti-inflammatory drugs known. Their use can substantially reduce the swelling, warmth, tenderness and pain that is associated with inflammation. While steroid dosage should be kept at the lowest effective level, steroids must not be stopped suddenly if they have been taken for more than four weeks. After that time, some shrinking of the adrenal glands will occur, and they may not produce enough cortisone if the synthetic steroids are discontinued abruptly. A slow reduction in the dosage of steroids allows the adrenal glands to regain their ability to manufacture natural cortisone.
Prednisone is the synthetic corticosteroid preparation most often used in the treatment of lupus.
It may be given as often as four times each day, as infrequently as once every other day, or at any frequency in between. Occasionally, very large doses of steroids may be given for a short period of time. Prednisone is an extremely effective drug and may be necessary to control active lupus. Although many lupus patients do not need to stay on steroids continuously, those with severe disease or active and serious kidney lupus may require long-term steroid treatment. There is usually prompt relief of most symptoms after initiation of treatment with corticosteroids.