My doc was worried about my organs - heart, kidney etc. when it was that high. It wasn't just my joints.
I found a 20 year study of women who had rheumatoid arthritis prior to the more aggressive approach that is used today. During that period, the standard treatment was to save the more aggressive drugs like methotrexate until later (there were no biologics) - the theory being that this was a lifetime disabling disease and the doctors needed to "save something for later". I can't remember the precise numbers and don't have the study in front of me but, if my memory is right, approximately 30% of these mostly young women at the start of the 20 years, were dead and most of the others were severely disabled. The study shifted the thinking to one of aggressively treating the disease at onset.
I went searching for the cause of death because I couldn't see why the mortality rate for RA was so much higher than in the general population. It turned out that most of the deaths were due to "cardiovascular incidents" - i.e. heart attacks and strokes. It seems that high levels of inflammation can attack the lining of arteries (as well as the heart and other organs) and clouds of fat cells are released into the arteries provoking heart attacks and strokes.
It became clear that getting inflammation levels down is crucial to minimize this kind of serious complication. That was why I was willing to go back on prednisone despite my fear of it.
