THE OFFICIAL NEWS SOURCE OF ACR CONVERGENCE 2022 • NOVEMBER 10-14



History of the quest to synthesize cortisone is compelling and still relevant

Eric L. Matteson, MD, MPH
Eric L. Matteson, MD, MPH

The annual Philip Hench, MD, Memorial Lecture this year honors the Nobel laureate who 70 years ago first described the use of glucocorticoids in rheumatoid arthritis. Annual Meeting attendees can learn the intriguing details of the work done by Dr. Hench and other scientists in the development of cortisone as a therapeutic agent.

Crossroads of History & Hope: Discovery & First Use of Cortisone for RAwill be delivered by Eric L. Matteson, MD, MPH, who will look back at a journey that began with the discovery of the importance of the adrenal gland by Thomas Addison in 1855 and continues today.

The Hench Memorial Lecture will take place from 2:30 – 3:30 pm on Tuesday in Room W375c.

Dr. Matteson, Emeritus John Finn Professor of Medicine and Emeritus Chair of the Division of Rheumatology at the Mayo Clinic in Rochester, MN, said he hopes to provide historical context to one of the most important — and at times dramatic — developments in rheumatology. Dr. Matteson has a long history of leadership in rheumatology, including serving as president of the Rheumatology Research Foundation from 2015-17.

“I’ll discuss the history of our understanding of the biochemistry of cortisone, but I also want to share the fascinating details surrounding the race to synthesize it,” Dr. Matteson said. “There was a fear during World War II that the Germans were working to synthesize cortisone to enable pilots to fly at very high altitudes without oxygen. So there was a national-defense interest in synthesized cortisone, and therefore it was a top research priority during World War II.”

Following the war, the defense significance waned but the interest in synthesizing it remained among researchers. That step was soon achieved by Edward Kendall at the Mayo Clinic. It was then synthesized by others, including Tadeus Reichstein in Switzerland and Lewis Sarett.

Sarrett worked in Kendall’s lab for months and then returned to Merck Laboratories, where he patented the process for large-scale synthesis of cortisone.

“The first patient with rheumatoid arthritis was treated with cortisone in 1948,” he said. “It was the first time cortisone was used for the treatment of any disease, and the results were really remarkable. Indeed, the results were regarded as sensational. Many thought that a cure for rheumatoid arthritis could soon be on the horizon. Researchers rapidly realized that was not the case.”

Dr. Matteson said the experiences of some patients were nearly miraculous. However, there were also tragic side effects that left lasting impressions on patients and clinicians alike.

He will also discuss the use and role of glucocorticoids in the management of rheumatologic diseases today.

“It’s been 70 years since it was first used by Hench, and cortisone derivatives still have a major role in the management of rheumatologic diseases,” he said. “I think this discussion will appeal to both researchers and clinicians because there is intense ongoing interest — both in the clinical application but also in the science of glucocorticoids. The area of glucocorticoid research is an extremely active one. We still don’t fully understand the biology of glucocorticoids and their effects on the immune system. We’re still learning how to apply glucocorticoids in the clinical setting.”

The Hench Memorial Lecture was established by the Hench Society at the Mayo Clinic in memory of Dr. Hench. Today, the ACR Rheumatology Research Foundation supports and manages the Hench Lectureship. Each year, the Foundation chooses an outstanding speaker who has made significant contributions to the field of rheumatology to receive this honor.