Acth or Corticosteroids?: A Critical Review of Results and Possibilities in the Treatment of Severe Chronic Disease

Summary

Some immunopathies, mainly rheumatoid arthritis and bronchial asthma, are in their severe forms treated with corticosteroids and/or ACTH. From the literature, the basis for the preference of either is critically analyzed. From clinical, physiological, and biochemical viewpoints it is concluded that an adequate comparison between these two treatments is difficult or impossible. Therapeutically differing results might be the outcome of patient selections, variations of therapeutic levels, and shortcomings of the present methods for evaluation of hypothalamic-pituitary-adrenal function.