Interference with the cortisol axis by the microtubule antagonist, CPH82.

Treatment with CPH 82, a mixture of two benzylidated podophyllotoxin glycosides, has been shown to improve inflammatory activity in patients with RA. The drug has few side effects but some patients have developed clinical features of Cushing's syndrome. We studied the hypothalamic-pituitary-adrenocortical axis in two female patients before and during treatment with CPH82. The results clearly demonstrate that CPH82 was associated with suppression of the endogeneous production of ACTH and cortisol with a concomitant paradoxical picture of clinical hypercortisolism. These observations suggest that CPH82 has glucocorticoid receptor agonistic effects.