Peptic Ulcer during Treatment of Rheumatoid Arthritis with Cortisone Derivatives

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Abstract
Summary On comparison between a necropsy material (31 cases) of rheumatoid arthritis, not treated with corticosteroids and a clinical material (69 cases), treated with corticosteroids the following has been observed: The ulcer frequency of the necropsy material, not treated with steroids was approx. 10 per cent; in the clinical material, treated with steroids (5—15 mg. prednisone or prednisolone daily for at least half a year), at routine x-ray examination of the upper gastrointestinal tract: 19 per cent. The risk of ulceration seems to be just as great for men as for women. Half the cases treated with corticosteroids had dyspeptic complaints. The symptoms of the verified ulcers were often very slight or atypical. None of the patients, who were quite free from gastric complaints during the treatment, had any provable ulcers. Complications like perforation or hemorrhage can appear rapidly. The risk of ulceration increases with the duration of the steroid therapy.