An androgenic steroid, chemically modified to have less masculinizing activity per unit anabolic activity, was studied in two patients with rheumatoid arthritis. In one patient, the anabolic steroid reversed both the nitrogen loss secondary to disease activity and the nitrogen loss secondary to corticosteroid treatment. In the other patient the effectiveness of the anabolic agent in promoting calcium retention was demonstrated.Un steroide androgenic, chimicamente modificate pro reducer su activitate masculinisante in proportion a su activitate anabolic, esseva studiate in duo patientes con arthritis rheumatoide. I n un patiente, le steroide anabolic reverteva tanto le perdita de nitrogeno secundari a1 activitate del morbo como etiam le perdita de nitrogeno secundari a1 tractamento con corticosteroide. I n le altere patiente le agente anabolic se provava efficace in promover le retention de calcium.ORTICOSTEROIDS have assumed an increasingly important role in C medicine, even though their therapeutic use often has been accompanied by serious deleterious consequences. It is known that ACTH and cortisone may produce a negative nitrogen balance and it is probable that osteoporosis associated with prolonged steroid therapy is in considerable degree due to this phenomenon. Numerous investigators have demonstrated that the male sex hormone can induce nitrogen and mineral retention1,2 and the consequent development of new protein matrix.3 The chief drawback to the clinical use of androgens, however, has been the production of masculinizing effects. A more recently synthesized analogue of testosterone, 17-alphaethyl-17-hydroxy-19 nor 4-androstene-3-one (Nilevar), lias been reported to be as potent an anabolic agent as testosterone, while possessing only a fraction of its androgenic properties. An effort has been made to evaluate this agent in metabolic studies of two cases of rheumatoid arthritis.
METHODSTwo patients with rheuni.itoit1 arthritis were chosen for study. One had recently acquired rapidly advancing disease. The other had chronic, relatively inactive disease which had left the patient bedridden. These patients were placed on a constant composition liquid diet+." and their total food intakes were recorded at intervals in volume$. Aliquot4 of the
