Metacortandracin and 9-alpha-fluoro hydrocortisone acetate in rheumatic diseases.

Among the pharmacological problems raised by the study of the biological properties of cortisone is the existence of other substances exhibiting the same or similar properties. Hydrocortisone is already in practical use, and although not much more active than cortisone, in the acetate form it presents greater local antiphlogistic activity. Aldosterone which has been introduced into medical use in the last 2 years, has a marked action on electrolyte metabolism, but its antiphlogistic action is nil. Recently three new steroids possessing anti-inflammatory properties superior to those of cortisone have been reported: 9-m-fluoro hydrocortisone (Boland and Headley, 1954; Ward and others, 1954), metacortandralone and metacortandracin (Bunim and others, 1955; Ballabio and others, 1955, a, b; Sala and others, 1955, a, b). Bunim states that metacortandralone represents a great step forward in the treatment of rheumatic diseases with adrenal hormones because it is three or four times more active than cortisone, and does not affect the electrolyte and the nitrogen metabolism unfavourably, at least within the limits of therapeutically active doses. This report deals with our clinical experience in the last 3 months in the treatment of rheumatic diseases with metacortandracin and 9-a-fluoro hydrocortisone. Material This study was conducted with 36 patients, some of whom have been under our control for several years. This facilitated comparison with previous treatments, as the results could be exactly defined over a long period.