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October 15, 1960

Chemically Modified Adrenocortical SteroidsAn Appraisal of Their Relative Therapeutic Efficiencies in Rheumatoid Arthritis

Author Affiliations

Los Angeles

From the Department of Medicine, St. Vincent's Hospital and the University of Southern California School of Medicine.

JAMA. 1960;174(7):835-841. doi:10.1001/jama.1960.03030070013003

The desired antirheumatic effects can be obtained equally well from prednisone, prednisolone, methylprednisolone, triamcinolone, dexamethasone, and fluprednisolone provided they are given in effective dosages. With each drug, however, it is necessary to consider the ratio of the effective dosage to the dosage that will cause its own characteristic undesirable side-effects. This ratio (therapeutic index) is about the same for prednisone, prednisolone, and methylprednisolone, all of which are superior in this respect to cortisone and hydrocortisone and are preferred for routine use in rheumatoid patients requiring steroid administration. Triamcinolone and dexamethasone are considered special-purpose steroids, and fluprednisolone, on the basis of preliminary data, is believed to be a satisfactory antirheumatic agent free from salt-retention effects.