How often can you have prednisolone?

How old is he? Pred is not a great thing for anyone to be on too much but if your son is still growing the pred can interfere with that process. That is another thing that has to be considered when prescribing it to children - on top of the other thousands of reasons. I don't think there are any answers to your question written down in any books anywhere.

Thanks for replies - he's 21 - and yes you're right the mezavant isn't working. So could he have another course starting at 40 again? Seeing gi on 21 Jan - don't want to go on anti-tnf - any ideas?

Sounds like your son is prednisone-dependent. You'll need some stronger meds so he can stay off of the pred. As pred is on of the most dangerous uc meds over the long term as it can cause type ii diabetes, osteoporosis, glaucoma, and other nasty things. Why are you afraid of the biologics? They rarely have side effects, and the odds of them helping are high. I was pred-dependent before remicade, it has worked wonders for me.

a.) You had said the cancer odds are low with biologics but I am not sure you know how really low they actually are.The odds of lymphoma for the average Joe on the street (no meds, no uc) is 2 in 10,000 (or 0.002%), the odds of lymphoma for somebody on biologic meds remicade/humira is 6 in 10,000 (or 0.006%). Very low odds. I would argue that your odds of cancer from uncontrolled/untreated uc is much higher than with the biologics. As inflammation from uc can turn into dysplasia which then becomes cancer over time.

b.) Humira might be worth a shot as some of the people here have had success with it. New meds are coming out all of the time, so that does pose some hope that if humira stops working that there will be something else to try. Right now there is also SIMPONI (golimumab) on the market which a couple people are trying out here. In the near future there is Vedolizumab (trade name Entyvio) that is currently going through FDA approval process and it uses a very different process than the other biologics (it isn't a TNF-alpha blocker like all of the rest but something entirely different). Who knows Humira may work for him indefinitely and keep him in a solid remission for years, don't know unless you try. The future is very hard to read or predict, what matters now is what improves your son's quality of life today.

Sounds like your son developed antibodies to remicade making it ineffective for him. He should also be on an immunosuppressant (e.g., 6mp, imuran, aza) at the same time as the biologic, as that decreases the odds of him developing antibodies and I would recommend that in the future.

What about surgery?

Read your sig. Year out of his life, then that's it: no more UC or toxic meds ever again, for the rest of his life. (Pred being the most toxic, dangerous and useless med out of them all.)

Ok - been to the gp who has put Will on a course of pred just to buy us time - he's going to the loo a lot and his back is so stiff. Seeing the gi at St Marks in London on 21 Jan so will talk then. Nicecupoftea we have seen the surgeons at St Marks and discussed it - only problem is don't want to have surgery and find he needs a biologic anyway for the AS which could sort both. Ipoop you've been really helpful - you sound really knowledgeable - are you medical or just researched? Your statistics make me feel more confident. It'S only his second pred in about 15 months so just hoping it won't hurt too much. But need to sort. Will keep you updated. It's crap at 21 to have all this.