Question
I have RA which at present is uncontrolled. I have been on SSZ which put the RA into semi remission for a couple of years and then failed. I have been taking MTX/SSZ/HCQ for 18 months now with no result. My RD has suggested gold with a 6 week course of 7 mg daily prednisone, but I also have what appears to be idiopathic AVN of the left hip. I am worried about taking the prednisone because of the possibility of more avn. Is my worry justified ? I would also like to get my hip fixed asap (a THR)but the orthopedic sugeon has agreed that it would best to get the RA under control first.
Answer
Gold shots are almost never given in the U.S. anymore. In fact, it has been very hard to get becasue there is no company who is making it. By contrast to the newer agents, gold is not very well tolerated and the initial weekly injections are a hassle.
Prednisone below 10 mg daily will likely not have an effect on your AVN and thus if you require it, it may be a reasonable consideration.
