It has been shown in controlled trials by the joint com- mittee of the Medical Research Council and Nuffield Foundation (1954, 1955) and by the Empire Rheumatism Council (1955, 1957) that the average case of rheuma- toid arthritis fares as well with aspirin as with cortisone.However, there are certain cases which remain active in spite of treatment with rest in hospital and salicylates or gold, and some of these we have treated with cortico- steroids, a number of them continuously for six years.In the early days we gave oral cortisone for preference, but owing to the shortage of supplies we sometimes used corticotropin (A.C.T.H.) as an alternative.When reporting to the Medical Research Council three years ago we found that we had then treated 50 cases with cor- tisone, and in only two had we been able to stop the drug on account of a remission; whereas of 42 who had received corticotropin we had been able to withdraw the drug in 12.Treatment with cortisone, its newer analogues pred- nisone and prednisolone, or corticotropin is not in- frequently associated with serious side-effects.The suggestion, therefore, that clinical remission occurred in more cases treated with corticotropin than with corti- sone indicated that further observations might give valu- able information, though the disadvantages of daily in- jection had to be accepted.Since the original report of Hench, Kendall, Slocumb, and Polley (1949) on the clinical effects of cortisone and corticotropin, efforts have been made to discover methods of measuring adrenocortical activity.In 1950 Porter and Silber reported studies on urinary steroids, whilst in 1955 Appleby, Gibson, Norymberski, and Stubbs published a method of estimating total 17- hydroxycorticosteroids (17-(OH)CS) in urine which could be carried out as a routine laboratory procedure.Since this method is a measure of glucocorticoid metabolism it
No takes yet. Share an insight, caveat, or question.
Savage et al. (1957) studied this question.