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Observations concerning the antirheumatic and physiologic effects of a new synthetic corticosteroid, dexamethasone, are presented. This preparation, the most potent of any steroid heretofore studied, did not cause sodium retention or potassium loss in doses sufficient to suppress rheumatoid disease. Increased nitrogen and calcium excretion were observed. Further clinical studies are indicated. For the present, it is suggested that the daily dose of dexamethasone should not exceed 4 mg.Es presentate observationes relative a1 effectos antirheumatic e physiologic del nove corticosteroide synthetic, dexamethasone. Iste preparato, le plus potente de omne le steroides usque nunc studiate, non causava retention de natrium o perdita de kalium quando usate in doses sufficiente a supprimer morbo rheumatoide. Augmentos del excretion de nitrogeno e de calcium esseva observate. Studios clinic additional es indicate. Por le momento, il es suggerite que le dose diurne de dexamethasone non excede 4 mg* EXAMETHASONE' is delta-1,Y-a fluoro,l6a methyl hydrocortisone. In D other words, it is a prednisolone analog to which have been added a fluorine atom at carbon 9 and a methyl radical at carbon 16. This compound was synthesized by a team of scientists1 who studied its glucocorticoid, mineralocorticoid and anti-inflammatory properties in rats and found it to have the following potencies: adrenal atrophy, 700 times hydrocortisone involution of thymus, 400 times hydrocortisone granuloma inhibition, 190 times hydrocortisone body weight depression, 100 times hydrocortisone and glycogen deposition, 17 times hydrocortisone. In adrenalectomized rats dexamethasone produced neither sodium retention nor potassium loss.It will be recalled that prednisone was the first of the synthetic, biologically active 11,17 oxysteroids that was found to have enhanced anti-inflammatory potency (compared to hydrocortisone) and yet was free of the objectionable effects of sodium retention and potassium loss2 It was not, however, free of ~~

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