Study of the adrenal response to ACTH after prolonged treatment with prednisone alone or in combination with ACTH or testosterone

Summary 

In six series of 6 subjects each who received prolonged treatment with prednisone for various rheumatic conditions their adrenocortical responsiveness was tested at the end of the treatment by an intravenous perfusion of ACTH. Quantitative analyses of plasma 17-hydroxycorticosteroids were made prior to and during the infusion. Twelve hours after discontinuation of therapy there was no response; after 36 and 60 hours the curves were very disordered and 6 1/2 days after discontinuation, the responses, although subnormal, were more regular. Adrenal unresponsiveness cannot be prevented by administration of testosterone concurrently with the corticosteroid therapy; on the contrary, combining regular injections of long-acting ACTH (25 mg. every 5 to 7 days) resulted in normalizing adrenal reactivity to corticotropin 12 hours after discontinuation of the corticosteroid treatment.

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