The effect of short, intensive courses of corticotropin (100 units intravenously, daily for ten days) was studied in patients with generalized myasthenia gravis. A decrease in strength and response to anticholinesterase medication occurred during 21 of 22 courses in seven of eight patients. Following termination of corticotropin, moderate to marked improvement occurred after 13 of 21 courses in four of seven patients, and lasted an average of seven weeks. The exacerbation and improvement were more pronounced in patients with more severe myasthenia, and following repeated courses of corticotropin. The improvement was proportional to the severity of the exacerbation. The effects of corticotropin could be simulated by typhoid-paratyphoid vaccine. Despite exacerbation of the disease during hormone administration, repeated courses of corticotropin are useful in the management of most cases of severe myasthenia gravis.
Grob D, Namba T. Corticotropin in Generalized Myasthenia GravisEffect of Short, Intensive Courses. JAMA. 1966;198(7):703–707. doi:10.1001/jama.1966.03110200059018