Abstract
To the Editor.— It may be that 40 to 60 mg of triamcinolone acetonide once a month is not as effective in treating arthritis or asthma as it is in steroidresponsive dermatoses. If so, Klinefelter and associates (241:2721, 1979) have performed a useful service in promoting the single morning or evening dose of prednisone by showing that either one, up to a daily dose of 15 mg, spares the hypothalamicpituitary-adrenal axis just about as well as alternate-day therapy does. However, their implication that this is the only harmful effect of taking 450 mg of prednisone a month seems questionably optimistic; it is likely that many patients will ultimately show development of osteoporosis or cataracts, or both, at this dose level, which is seven to ten times as high as that required if intramuscular triamcinolone is used. Moreover, one should consider the probability that a great many patients, supplied with prednisone
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