Since Hench, Kendall, Slocumb and Polley1 first reported that the adrenal cortex hormone, cortisone, exerts strikingly beneficial effects on rheumatoid arthritis, several other investigators have confirmed their observations.2 The hormone produces prompt and definite suppression of the disease, but its action is usually temporary and relapse ensues when administration is stopped. Cortisone therapy, therefore, is not curative, and it appears that improvement is maintained only by continued administration. Furthermore, adverse side effects may attend its use because the hormone influences a wide variety of metabolic functions. Hence, if cortisone is to become a therapeutic agent, methods for prolonged administration must be devised which will avoid or minimize the unfavorable reactions and yet preserve its effectiveness.
USUAL PATTERN OF CLINICAL IMPROVEMENT: REPORTED EXPERIENCES
When adequate doses of cortisone are given to patients with rheumatoid arthritis, a fairly uniform pattern of improvement results.3 Within a few days (or hours
BOLAND EW, HEADLEY NE. MANAGEMENT OF RHEUMATOID ARTHRITIS WITH SMALLER (MAINTENANCE) DOSES OF CORTISONE ACETATE. JAMA. 1950;144(5):365–372. doi:10.1001/jama.1950.02920050005002
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