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Drug Spotlight Program: Systemic Corticosteroid Therapy: Pharmacology and Endocrinologic Considerations

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▸Requests for reprints should be addressed to James C. Melby, M.D., Professor of Medicine, Boston University Medical Center, 750 Harrison Ave., Boston, MA 02118.

Boston, Massachusetts

Ann Intern Med. 1974;81(4):505-512. doi:10.7326/0003-4819-81-4-505
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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.





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