Clinical Comparison of the Newer Anti-Inflammatory Corticosteroids

Abstract

Our experience with 8 antirheumatic corticosteroid compounds has shown that none of them approximates to our ideal of a suppressive agent for rheumatoid arthritis and other steroid-responsive conditions. Some of the analogues exhibit qualitative differences in one or another physiological action, but the major deterrent features of corticosteroids are shared by each of them. Prednisone, prednisolone, methylprednisolone, fluprednisolone, and paramethasone seem to have similar therapeutic indices; and there appears to be little to choose between them for the ordinary patient who requires steroid therapy. Conversely, because they produce unique reactions of their own and because they have greater proclivity to certain troublesome side-effects, the therapeutic indices of dexamethasone, betamethasone, and triamcinolone are lower than that of prednisolone; they are less desirable for routine use and are best employed for selected cases as "special purpose" steroids.