What happens if oral steroids are used to treat psoriatic arthritis and then withdrawn?

• A. Life-threatening rebound flare
• B. Stable Remission
• C. No Effect
• D. Worsening Osteoporosis

Answer: (A)

When oral steroids are used to treat psoriatic arthritis and then withdrawn, the important idea is that stopping them abruptly can unleash a rebound inflammatory flare. Prolonged glucocorticoid use suppresses the body's own cortisol production, so stopping suddenly removes the drug’s anti-inflammatory effect while the body's axis may still be suppressed. That combination can lead to a sudden surge in joint inflammation, symptoms, and disability, and in some cases, adrenal insufficiency can occur, which can be life-threatening if not recognized and managed. Therefore, a gradual taper and transition to disease-modifying therapies are essential to maintain control and prevent a dangerous rebound.

The other options don’t fit as well. Stable remission is unlikely once the steroid is stopped without another effective long-term therapy in place. No effect would ignore the well-documented rebound risk after stopping systemic steroids. Worsening osteoporosis is a consequence of long-term steroid use itself, not an immediate outcome of stopping the medication, and while bone loss is a concern with steroids, it’s not the acute issue driving the rebound risk after withdrawal.