The History of Corticosteroids (Glucocorticoids)

By Chris Faubel, MD –

  • The discovery of the class of corticosteroid called glucocorticoids began in the 1920′s.

    Image courtesy A.D.A.M.

  • In the 1920’s, rheumatoid arthritis and other arthritidies were thought to have an infectious cause.
  • By 1938, Dr. Philip Hench from the Mayo rheumatic disease service, noticed a 65yo doctor with arthritis that improved the day after becoming jaundiced.
    • He later noted 31 other cases of joint pain resolving, to some extent, with pregnancy, infections, and post-surgically.
  • The scientific community then abandoned the infectious theory and started to look at the adrenal glands — substance X
    • Multiple compounds were isolated from animal adrenals.
    • Compound ‘E’ seemed to work particularly well in animals.
  • World War II was progress, and so money was lacking, which left them frustrated.
    • Merck gave multiple researchers around the world the remaining 9 grams of compound ‘E’ – [make it work or drop this idea]
  • In September 1948, they injected their first human patient.
    • A 29-yo female with severe, erosive arthritis that was chair-bound (unable to ambulate)
    • After 4 days post-injection of compound E, she was able to walk out of the hospital.
  • In 1950, Dr. Hench won the Nobel Prize in Medicine.

Compound E ended up being = Dehydrocorticosterone

FUN FACT: It took 3000 pounds of animal adrenal gland to make 1-gram of compound A

SOURCE:
1)  http://rheumatology.oxfordjournals.org/cgi/content/full/41/5/582

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This post was written by:

Christopher Faubel, MD - who has written 183 posts on The Pain Source.

Pain Medicine Fellowship (2011/2012) - Louisiana State University

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Christopher Faubel, MD

Pain Medicine Fellowship (2011/2012) - Louisiana State University

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