Prednisone (corticosteroid) is a very effective and quick-acting medication that shuts down inflammation in a variety of conditions including arthritis, lupus and vasculitis. It is very beneficial for getting one’s disease under control and helping your child feel better quickly. However, it is associated with many side effects with long-term use. As such, our approach is to use prednisone for as short a time and at as low a cumulative dose as possible. We often will introduce a ‘maintenance’ treatment at the same as, or shortly after, starting prednisone that will eventually take over controlling the disease once prednisone has been weaned down. We often use the metaphor of ‘putting out a fire’ – prednisone is the big hose of water to put it out quickly, while the maintenance treatment helps to prevent the fire from recurring. Typically these treatments have less side effects than prednisone. Of note, it is very important that prednisone is not stopped abruptly, as your child’s body is not used to producing its own cortisol which can lead to problems.