Frankly the researchers at the Symposium acted like it was a 'no brainer' that the vast majority of people with WG *should* be coming off of pred and having their disease controlled solely by immunosuppressant, and/or at other points having a medication free remission. As I have said many times, I met several people at the Symposium who were either off meds, and had been for a few years, or were currently flaring but had been off meds for a long time (in one guy's case more than 20 years). I think that what the researchers know is that docs who are not as familiar with the disease leave people on pred for a long period of time, because it helps to treat symptoms that really should be controlled by more/a different kind of immunosuppression. I met people there who would just have the pred being pushed up down up down constantly, with their main engine (mtx, cellcept, ctx, imuran) always staying at the same level. Kind of ridiculous.
I add too that my ENT has done more than 100 saddle nose repairs (and many people with these do have 'limited' disease with just upper resp involvement) and has only once operated on a patient who was on any meds whatsoever, and that was 2 mg daily pred.
My rheumy believes that pred is such a dangerous drug that docs should generally be trying to get their patients off of it all together, if that is at all feasible for their case, or never start it at all with them (which he has done in a few cases, including mine).
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