Combined salicylate, corticotropin and corticosteroid therapy in acute monocyclic rheumatic pancarditis. A preliminary report.

The first published accounts of the effects of corticosteroid and corticotropin on acute rheumatic carditis by Hench and co-workers in 1949 501.2 precipitated an enthusiastic clinical investigation of these hormones and their analoguese. An attitude of mounting optimism prevailed.3-8 In general, investigators concerned themselves with the relative merits and the toxic or untoward effects of various hormone regimens as opposed to salicylates, and related the disease response to the amount and duration of the medication administered.’54 The treatment failures were usually proportional to the time elapsed prior to treatment. On this idyllic scene, the joint report of the “Cooperative Clinical Trial” (1955) cast a pall of disenchantment. In a study of 497 children with acute rheumatic fever, they concluded that neither cortisone nor corticotropin was superior to aspirin, either in terms of the response of the acute disease or of residual heart damage one year later.9