What is the recommended dose of Prednisolone (prednisolone) for a psoriatic arthritis flare?

From the Research

For a psoriatic arthritis flare, prednisolone is typically prescribed at a low dose of 10 mg on alternate days, as evidenced by a case study where this regimen controlled symptoms within a week 1. The specific dose depends on flare severity, patient weight, and comorbidities.

• The medication should be taken in the morning with food to reduce gastrointestinal side effects and minimize sleep disturbances.
• Prednisolone works by suppressing inflammation through inhibition of inflammatory mediators and immune cell function, providing rapid symptom relief while longer-acting disease-modifying treatments take effect.
• Short-term use helps avoid serious side effects associated with prolonged steroid therapy.
• Patients should continue their regular psoriatic arthritis medications during the prednisolone course and contact their healthcare provider if symptoms worsen or don't improve within a few days.
• Blood glucose monitoring is advisable for diabetic patients, and calcium/vitamin D supplementation may be recommended during treatment. The use of methotrexate, a disease-modifying antirheumatic drug (DMARD), is also supported by evidence, with low-quality evidence suggesting that low-dose (15 mg or less) oral methotrexate might be slightly more effective than placebo when taken for six months 2. However, the most recent and highest quality study on the use of prednisolone in psoriatic arthritis flares is limited, and therefore, the recommendation is based on the available evidence and clinical experience.
• The dose of 10 mg on alternate days is a reasonable starting point, with adjustments made based on patient response and tolerance.
• It is essential to monitor patients closely for signs of toxicity or adverse effects, particularly with long-term use.
• The combination of prednisolone with methotrexate or other DMARDs may be considered in patients with severe or refractory disease, as evidenced by the study where the addition of prednisolone to methotrexate improved therapeutic outcome in severe psoriatic arthritis 1.