Clinical and Physiological Studies on the Use of Metacortandracin in Respiratory Disease

I. Bronchial Asthma

¹ The Department of Medicine, College of Physicians and Surgeons, Columbia University and the Presbyterian and Goldwater (Columbia Division) Hospitals, New York City, New York.

A preliminary report on the use of metacortandracin in 30 patients with bronchial asthma is presented. The clinical findings of short term therapy with this steroid include: (1) disappearance or relief of bronchospasm and asthmatic dyspnea in 29 instances; (2) the capacity to eat a regular diet with added salt and without the use of supplementary feeding of potassium in patients without heart disease, in contrast to the need for a salt poor diet and potassium administration with the administration of cortisone, hydrocortisone and ACTH; (3) in 5 patients previously on maintenance therapy with hydrocortisone, the substitution of metacortandracin for hydrocortisone resulted in average weight loss of 6 pounds occurring in a period of one week. In 6 patients mooning of the face became much less prominent. (4) The subjective effect of eating a regular diet in the cases without cardiac failure was a happy one. (5) The side effects were slight, resembling, but to a lesser extent those seen with cortisone treatment, i. e., mental stimulation, abdominal discomfort, occasional headache and transient dizziness.

Respiratory function test confirmed the clinical impression of decrease or disappearance of bronchospasm.

Although further studies are required to supplement the findings of this preliminary investigation, it seems to the authors that this new steroid hormone is a drug of considerable value in the treatment of intractable bronchial asthma. Furthermore, in cases of persistent asthmatic dyspnea with an associated cardiac insufficiency, the safety of administering metacortandracin, in contrast to cortisone, became evident. The effect of this drug in lowering resistance to infection requires further study.

The long term evaluation of this steroid is not possible at this time, but it is to be emphasized that all of the side effects of cortisone, except for salt and water retention, at moderate dosages used, have already been observed. What their significance may be in the protracted management of certain bronchopulmonary disorders obviously cannot be stated at this time.