We reexamined the association between corticosteroid therapy and subsequent peptic ulceration or gastrointestinal hemorrhage by pooling data from 71 controlled clinical trials in which patients were randomized to systemic corticosteroids (or ACTH) or to nonsteroid therapy. Of 3064 steroid-treated patients evaluated for peptic ulcer, 55 ( per cent) had ulcers, as compared with 23 of 2897 controls ( per cent) (relative risk, ; 95 per cent confidence interval, to ). Of 3135 steroid-treated patients evaluated for gastrointestinal hemorrhage, 78 ( per cent) had bleeding, as compared with 48 of 2976 controls ( per cent) (relative risk, ; 95 per cent confidence interval, to ). The incidence of ulcers varied directly with the dosage of steroids. When separate analyses were performed for studies that were double-blind, used only oral steroids, used only parenteral steroids, or excluded patients with a history of ulcer, the trend remained consistent but did not always reach statistical significance. This study strongly suggests that corticosteroids do increase the risk of peptic ulcers and gastrointestinal hemorrhage.
The results obtained from a research on 100 patients of both sexes affected with bronchial asthma, chronic obstructive bronchopathy, rheumatoid arthritis, haematological disorders and some other pathological forms, all depending on steroid therapy, are reported in this paper. The treatment was carried out using a new chronopluricorticoid (Dutimelan 8 15). The clinical efficiency is comparable to that obtained by the traditional steroid treatment with the advantage that symptoms of hypercorticism were absent or insignificant. The authors believe that such excellent results are to be attributed to the particular chronopharmacological characteristics of this preparation.