Long-term use of prednisone and prednisolone in juvenile rheumatoid arthritis; a report of fifteen cases.

Abstract

This report describes observations on the continuous use of Δ-1 steroids, prednisone and prednisolone, in 15 patients with juvenile rheumatoid arthritis for periods ranging from 8 to 24 months and averaging 19 months. Except for one patient who was hospitalized for a two-month period, all patients were followed in an outpatient clinic. They were usually seen at two-week, occasionally at one-week, and rarely at four-week intervals. During the period of study, previously prescribed ancillary treatment, such as physiotherapy and aspirin, was continued, but no new therapeutic measures were initiated. Previous Studies Prednisone and prednisolone, synthetic crystalline steroids having similar biologic properties and effects, were introduced into clinical medicine as antirheumatic drugs by Bunim, Pechet, and Bollet in 1954. 1,2 They are analogues of cortisone and hydrocortisone, differing from these compounds only in having an unsaturated bond at carbon 1. Both in short- and long-term use, a pattern of clinical response