Oral hydrocortisone therapy in rheumatoid arthritis; an appraisal of general results of prolonged administration.

When hydrocortisone was made available for clinical trials in the spring of 1951, three facts seemed relevant: (1J The hormone was the principal, probably the natural, glycogenic steroid secreted by the adrenal cortex (Hechter, 1950; Hechter and others, 1951; Reich and others, 1950; Savard and others, 1952; Bush, 1951; Conn and others, 1951; Jacobsen and Pincus, 1951; Pincus, 1949; Mason, 1950). (2) It was considerably more potent than cortisone in certain metabolic activities, as measured by laboratory experiments in animals (Ingle and Kuizenga, 1945; Pabst and others, 1947). (3) It possessed antirheumatic activity, this having been demonstrated by Hench, Kendall, Slocumb, and Polley (1950) in a rheumatoid arthritic patient given 900 mg. of the substance over a 12-day period.