Ben-Chetrit E, Naparstek Y, Ehrenfeld M, Eliakim M
Clin Rheumatol. 1985 Jun;4(2):155-60. doi: 10.1007/BF02032286.
The effect of synthetic adrenocorticotrophic hormone (Synacthen), in conjunction with hydroxychloroquine, aurothioglucose, or penicillamine, was evaluated retrospectively in 21 patients with rheumatoid arthritis (RA). One mg of depo Synacthen was administered at increasing intervals of 4 to 14 days for a total period of 3 to 7 months. Fourteen patients with RA on either hydroxychloroquine or aurothioglucose and not on Synacthen, served as controls. Patients in the Synacthen group were, on the whole, sicker, as indicated by a lower functional capacity, higher mean erythrocyte sedimentation rate, and systemic and articular indices. Physicians' estimate of the patients condition after 1 - 2 months of therapy showed no improvement or deterioration in 10 out of 13 cases in the control group. Likewise, the erythrocyte sedimentation rate decreased significantly more and seronegativity was achieved in more of the Synacthen-treated cases. Six to 8 months after the beginning of therapy (1 to 4 months after cessation of Synacthen) clinical improvement was comparable in both groups, although seroconversion was more common in patients who had received Synacthen (7 out of 10 as compared to 1 out of 7 respectively). It is suggested that Synacthen may be used safely in the early phase of selected RA patients, until the effect of second-line drugs is achieved.
对21例类风湿关节炎（RA）患者进行了回顾性评估，以研究合成促肾上腺皮质激素（辛纳科特）与羟氯喹、金硫葡萄糖或青霉胺联合使用的效果。每4至14天增加剂量注射1毫克长效辛纳科特，共持续3至7个月。14例服用羟氯喹或金硫葡萄糖但未服用辛纳科特的RA患者作为对照。辛纳科特组的患者总体病情较重，表现为功能能力较低、平均红细胞沉降率较高以及全身和关节指数较高。治疗1至2个月后，医生对患者病情的评估显示，对照组13例中有10例无改善或恶化。同样，辛纳科特治疗组的红细胞沉降率下降更为显著，且更多患者实现了血清阴性。治疗开始6至8个月后（停用辛纳科特1至4个月后），两组的临床改善情况相当，尽管接受辛纳科特治疗的患者血清转化更为常见（分别为10例中的7例和7例中的1例）。建议在选定的RA患者早期可以安全使用辛纳科特，直到二线药物起效。
