Drug Spotlight Program

The biochemical and metabolic effects of the corticosteroids cannot be easily related to their desired anti-inflammatory and antiallergic therapeutic actions. Ordinarily, the corticosteroids have no place in the treatment of uncomplicated rheumatoid arthritis. Corticosteroid therapy is most important in those disorders requiring prolonged, high-dose and short-term intensive therapy. The complications of corticosteroid therapy can be largely reduced if the underlying disease permits alternate-day therapy. Suppression of the hypothalamic-pituitary-adrenal system is potentially the most hazardous complication of high-dose, prolonged corticosteroid therapy. This complication can be avoided by the institution of alternate-day therapy but it can become manifest up to 6 months after cessation of therapy.