Observations on new synthetic antirheumatic steroids and critical evaluation of prednisone therapy in rheumatoid arthritis

A Comparison of Prednisolone with Aspirin or other Analgesics in the Treatment of Rheumatoid Arthritis: M. R. C. Report

“…After 2 years of therapy the mean dosage in this trial was 10 mg. daily, which is still above the maximum of 9 mg. for men and 5 mg. for menopausal women recommended by Slocumb, Polley, and Ward (1957). Of the eight patients in the trial who received 20 mg. prednisolone daily over 3 months, four had evidence of peptic ulceration and a fifth developed psychosis-a proportion of serious complications which is clearly unacceptable, and this high incidence of complications with high dosage accords with the experience of others (Howell and Ragan, 1956;Black, Yielding, and Bunim, 1957).…”

Long-term Steroid Therapy in Chronic Intractable Asthma

“…It has been shown that the incidence of side-effects of steroids increases steeply when the dose of prednisolone or its equivalent is above 15 mg. daily (Black et al, 1957), and we have constantly tried to find the minimum effective dose of steroid which, with the free use of an inhaler and/or ephedrine or aminophylline, would allow the patient to lead an active and reasonable life. Only three of our patients were having 15 mg. of prednisone a day, all the rest were having 10 mg. or less.…”

Gastric ulcer and the anti-arthritic drugs

“…Bearing in mind all the variables mentioned earlier, one must still consider the massive evidence of correlation between peptic ulcer and steroid therapy (Kern, Clark & Lubens, 1957;Black, Yielding & Bunlin, 1958;Howell & Ragan, 1956;Edgecomb, 1958;Kammerer, Frieberger & Rivelis, 1958;Evans, 1958;Gedda & Moritz, 1959). The incidence of peptic ulcer in these series ranged from 12-5 to 31%.…”