TY - JOUR T1 - Matching Therapy to Body Rhythms: An Endocrine Approach to Treating Rheumatoid Arthritis JF - The Journal of Rheumatology JO - J Rheumatol SP - 1981 LP - 1982 DO - 10.3899/jrheum.100688 VL - 37 IS - 10 AU - MARNI N. SILVERMAN AU - ESTHER M. STERNBERG Y1 - 2010/10/01 UR - http://www.jrheum.org/content/37/10/1981.abstract N2 - The value and efficacy of corticosteroids in treatment of rheumatoid arthritis (RA) has been recognized ever since the Nobel Prize in Physiology and Medicine was awarded in 1950 for the astonishing discovery of Edward Kendall, Philip Hench, and Tadeus Reichstein1. The description of Hench’s treatment of the first patient with Kendall’s compound E (later known as cortisone) reads like a story out of the annals of the miracle cures at Lourdes2. The young woman, unable to walk and bedridden with severe debilitating RA for 4 years, gets up, walks and leaves hospital recovered, only 4 days after treatment with daily intramuscular injections of the drug. The Nobel Prize was awarded to this team only one year after this observation, and after treatment of another couple of dozen patients3. Prednisone has since been a mainstay of treatment of RA and other inflammatory/autoimmune conditions.The major stumbling block for this otherwise miraculous drug has been its severe side effects when used in high doses and for prolonged periods of time. These include adrenal insufficiency; osteoporosis; metabolic syndrome, including diabetes; central fat deposition; skin atrophy; “moon” face; impaired resistance to infection, with increased … Address correspondence to Dr. Sternberg. E-mail: sternbee{at}mail.nih.gov ER -