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Uses and Misuses of Adrenal Corticosteroids

Max Michael Jr., MD
JAMA. 1963;185(4):280-285. doi:10.1001/jama.1963.03060040064023.
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A VOLUMINOUS LITERATURE attests to the widespread, albeit often injudicious, use of the adrenal corticosteroids since their introduction a decade and a half ago. The entities for which they have been given comprise the entire gamut of syndromes, diseases, and general alterations of body structure and function. Uncritical enthusiasm generally accorded new types of drugs, failure to use appropriate controls in clinical studies, and sweeping conclusions often based on erroneous clinical impressions have resulted in much confusion as to the rightful place of the corticoids in our armamentarium. In addition, many of the uses have been purely empirical, and even at this time one cannot be dogmatic concerning the absolute indications for administration of these agents in most situations. The much needed control studies which continue to appear are slowly helping us to focus on the true indications, techniques of administration, and dosages of adrenal steroid therapy.

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