Alternate-Day Corticosteroid Therapy

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Abstract
The aim of this study was to devise a way of minimizing the adverse side-reactions of long-term corticosteroid therapy. The working hypothesis upon which we founded our hope of success is based upon the principle that substances in the blood stream tend to concentrate at inflamed sites and become fixed there.1-3 For example, trypan blue dye, when injected intravenously, will localize at a site of previously induced inflammation, staining the tissue deeply.1 Conventionally, steroids are given in divided daily doses. Presumably, this provides sustained blood levels. But if steroids do concentrate and fix at sites of inflammation, there would be no necessity for sustained blood levels. Indeed, the peak levels might be more important. Therefore, we decided to give single doses every other day. By reducing the duration of high levels, it was thought that adverse side-effects might be minimized, without weakening the therapeutic effect. This method would

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