Conversion from daily to alternate daily corticosteroids in rheumatoid arthritis

An attempt was made to convert 24 patients on corticosteroid treatment from a daily to an alternate daily regimen. Ten patients were successfully converted, 11 failed to convert, and 3 had to be withdrawn for irrelevant reasons. A simple tetracosactrin stimulation test gave some indication of which patients were more likely to convert successfully. Success was not influenced by severity or duration of disease, nor by dose of duration of steroid therapy. Conversion did not influence various clinical and laboratory measures of undesirable steroid side effects, but the follow-up period was probably too short to judge this. The evidence of others suggests that conversion is worth attempting.