The addition of phenobarbitone in therapeutic dosage to the drug regimen of prednisolone-treated subjects with rheumatoid arthritis produced measurable deterioration in the clinical status of the patients associated with a more rapid clearance of prednisolone from plasma. It is considered that phenobarbitone induced the hepatic metabolism of prednisolone, effectively reducing the steady state plasma level and resulting in clinical relapse. A slight but significant improvement in the adrenocortical response to tetracosactrin (Synacthen) was noted after phenobarbitone therapy.
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