Single daily dose corticosteroid treatment.

Abstract

. (1976). Annals ofthe Rheumatic Diseases, 35,[73][74][75][76]. Single daily dose corticosteroid treatment. Thirteen patients with rheumatoid or psoriatic arthritis who had not previously received corticosteroids were treated with prednisolone in a single dose each morning. Insulin-hypoglycaemia tests were performed before starting steroids in each patient, and again at the conclusion ofthe study in twelve of the thirteen (duration of steroid treatment 8-40 m). There was no difference in the mean basal or peak levels of corticosteroids, or the mean peak of growth hormone (GH) in the tests done before or during treatment, although one patient lost GH responsiveness. There was thus no evidence of hypothalamo-pituitary-adrenal (HPA) suppression in any of the twelve patients, and there was a good therapeutic response in twelve out of thirteen. One patient was dropped from the trial because treatment failed. In contrast, of seven patients who had received a similar total dose of prednisolone twice daily, three showed HPA suppression and two had lost GH responsiveness.

Hypothalamo-pituitary-adrenal Axis and Growth Hormone Axis in Patients with Rheumatoid Arthritis

“…Pituitary gland ACTH secretion may also be impaired. In contrast to our ¢ndings, Myles et al (26) reported a normal plasma corticosteroids response to ITT 20 years ago. But in that study the patient population was not characterized su¤ciently and diagnostic criteria for RA were not reported.…”

Low‐dose corticosteroids in rheumatoid arthritis. A meta‐analysis of their moderate‐term effectiveness

“…Of the 25 studies excluded from either metaanalysis, 12 did not randomize subjects (8,(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39), 3 used an average corticosteroid dose >15 mg/day (38,40,41), and 7 were of <3 months' duration (31,35,(42)(43)(44)(45)(46). Six other studies were excluded: 1 contained outcome measures which were not comparable to those of the other 30 …”

A pilot study of adrenal suppression after dexamethasone therapy as an antiemetic in cancer patients

“…Degree of adrenocortical suppression is known to be influenced by treatment duration, the type of steroid employed and its dosage, the administration route, and even by the time of day of the administration [13,14]. However, adrenal response in patients treated with glucocorticoids shows little correlation with dose or treatment duration [15,16].…”