ABNORMAL HYPOTHALAMIC-PITUITARY-ADRENAL AXIS FUNCTION IN RHEUMATOID-ARTHRITIS - EFFECTS OF NONSTEROIDAL ANTIINFLAMMATORY DRUGS AND WATER IMMERSION

Objective. To investigate the effects of nonsteroidal antiinflammatory drug (NSAID) therapy and water immersion on hypothalamic-pituitary-ad renal (HPA) axis function in rheumatoid arthritis (RA). Methods. Plasm a levels of adrenocorticotropic hormone (ACTH) and serum and urine lev els of cortisol were compared in untreated RA patients, NSAID-treated RA patients, and healthy control subjects. Results. ACTH levels were s ignificantly higher in untreated RA patients (mean +/- SEM integrated area 11,377 +/- 5,246 hours ng/liter) than in NSAID-treated RA patient s (2,285 +/- 388 hours ng/liter) or healthy controls (1,845 +/- 35.5 h ours ng/liter) (P < 0.001). Serum and urine cortisol levels were not s ignificantly different between groups. Two-hour head-out water immersi on had no effect. Conclusion. Elevated ACTH levels without hypercortis olemia occur in untreated RA. NSAID therapy alters HPA axis response, but immersion has no effect.