1968 Volume 44 Issue 9 Pages 1007-1015,968
In order to evaluate the clinical usefulness of synthetic β1-24 ACTH preparations (Ciba 30'920-Ba and Ciba 36'716-Ba), their adrenocortical stimulating effects were compared with those of natural ACTH preparations by measuring daily urinary 17-OHCS excretion. Urinary 17-OHCS excretion was measured by means of a modification of the method of Reddy, Jenkins and Thorn.
1) The 8-hour intravenous infusions of 25 I.U. of NH-ACTH (Organon) and 0.25 mg. of Ciba 30'920-Ba were performed at intervals of 4 days in 7 patients with various diseases and 2 normal subjects. These two ACTH preparations showed almost the same adrenocortical stimulating effects on the same subjects. Mean daily urinary 17-0HCS excretions in 9 subjects were 4.21 mg./day on the 2 days before, 13.7 mg. on the day of and 4.08 mg. on the day after the administration of 25 I.U. of NH-ACTH. With the administration of 0.25 mg. of Ciba 30'920-Ba, they were 4.13 mg./day, 13.7 mg. and 4.55 mg., respectively.
2) Five patients who had shown local and/or general allergic reactions to the intramuscular injection of ACTH-Z (Organon) gave positive skin reaction to NH-ACTH, and 4 of these patients gave positive skin reaction to highly purified ACTH (HP-ACTH, Organon), too. However, none of them gave positive skin reaction to Ciba 30'920-Ba. Three patients who were hypersensitive to NH-ACTH received 0.25 mg. of Ciba 30'920- Ba without showing any side effect and their urinary 17-OHCS increased significantly.
3) Intramuscular injections of 25 I.U. of Ciba 36'716-Ba for 3 successive days caused only a slight increase in urinary 17-OHCS in 8 normal subjects, but 50 I.U. of this preparation administered in the same way brought about a significant increase in 8 normal subjects. This increase corresponds in amount to that caused in 10 normal subjects by 20 I.U. of ACTH-Z administered in the same way.
4) A single intramuscular injection of 100 I.U. of Ciba 36'716-Ba caused an increase in urinary 17-OHCS which lasted for 3 days. These results seem to support the therapeutic usefulness of this preparation.
It is concluded that the synthetic ACTH preparations have an advantage over the natural ACTH in clinical use.
