The use of hormones in rheumatic diseases

Cortisone, hydrocortisone, and corticotropin may produce remarkable benefits in various types of rheumatic disorders. The manner of action of these potent hormones to produce antirheumatic effects is not known. The effects are temporary, suppressive but not curative, and there is no evidence that the ultimate course of a chronic rheumatic disease is favorably altered. There are potential dangers involved, because of which great care and definite precautions must be taken. The limitations of their usefulness have prevented the routine use of these agents in inflammatory rheumatic diseases. Indeed, the use of hormone therapy has become highly selective, for the purpose of realizing definite objectives. The physician using these substances should realize their limitations and potential problems. Troubles must be expected to occur in some patients and the physician should be prepared to meet them. One must consider not only what may happen during their administration, but also what might occur after they are discontinued. Although the practical usefulness of adrenal hormones has not fulfilled the high hopes originally held, despair is not warranted. Research continues and it is reasonable to anticipate that some current problems will be solved. The management of patients with rheumatic diseases should become more effective and on a firmer scientific basis.