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Status of the hypophysis-adrenal cortex system during treatment with glucocorticoids by the method of intermittent (every other day) administration
Authors:G S Zefirova  G V Ibragimova  M Sh Be?sugurov  B I Shmushkovich
Abstract:The authors discuss the advantages of the use of glucocorticoids in the treatment of autoimmune diseases, if the drugs are administered every other day. A total of 149 patients with autoimmune thyroiditis, endocrine ophthalmopathy, myasthenia and bronchial asthma were examined. Of these, 3 patients received glucocorticoids every other day, whereas the remainder took them every day. The former method consisted in the use of a single daily dose of glucocorticoids (20 to 80 mg) at 7 to 8 o'clock in the morning over 2 months to 5 years. The function of the pituitary-adrenal system was tested by the measurement of the blood content of ACTH, hydrocortisone and testosterone with the aid of a kit of standard tests. It was shown that glucocorticoids administered every other day did not produce any suppression of the pituitary-adrenal system in contrast to those who received prednisolone every day. The lack of the side effects in the form of exogenous hypercorticoidism can be explained by the anabolic action of steroid hormones produced by the reticular zone of the adrenal cortex. Examination of the blood serum content of testosterone in women who received glucocorticoids every other day has demonstrated that modulations in its secretion were similar to those in the content of ACTH and hydrocortisone. Thus, the stimulating hormonal therapy with glucocorticoids administered every other day appears more physiological as compared to the daily schedule.
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