Glucocorticoids are amongst the most prescribed medications in the world, with 50 million people, or 1% of the world's adult population taking long-term glucocorticoids.[1] They are both a panacea and a poison and the toxicities associated with their usage likened to an epidemic.

It is therefore heartening to read in a comment piece in The Lancet Rheumatology the Steritas Glucocorticoid Toxicity Index (GTI), a clinical outcome assessment (COA) to measure and monitor steroid-toxicity, has now been used in more than 70 clinical studies, including 12 phase 3 clinical trials.[2]

This prompted us to look into global usage of the GTI:

• Over 600 sites
• Over 80 countries
• In 22 inflammatory disease indications

Trials to date

Trials using either the GTI, or its pediatric sibling the pGTI, have covered more than 20 disease indications, including (but not limited to):

1. ANCA Associated Vasculitis,
2. Asthma,
3. Autoimmune Bullous Dermatosis,
4. Bullous Pemphigoid,
5. Cardiac Sarcoidosis,
6. Congenital Adrenal Hyperplasia,
7. Giant Cell Arteritis (GCA),
8. Sarcoidosis,
9. Granulomatosis with Polyangiitis (GPA),
10. Idiopathic Inflammatory Myopathies,
11. Inflammatory Rheumatism,
12. Juvenile idiopathic arthritis,
13. Lupus Nephritis,
14. Microscopic Polyangiitis (MPA),
15. Minimal Change Disease, Nephrotic Syndrome,
16. Pemphigus,
17. Pemphigus Foliaceus,
18. Pemphigus Vulgaris,
19. Polymyalgia Rheumatica (PMR),
20. Rheumatoid Arthritis,
21. Systemic Autoimmune Disease,
22. Systemic Lupus Erythematosus (SLE),
23. Vasculitis.

References

1. Fardet L, Petersen I, Nazareth I. Prevalence of long-term oral glucocorticoid prescriptions in the UK over the past 20 years. Rheumatol Oxf Engl. 2011;50:1982–1990.
2. Jobson J.C., Dawson J., Ndosi M., Assessing glucocorticoid toxicity: are the measures sensitive enough? The Lancet Rheumatology, Volume 5, Issue 3, 2023, e113-e114, https://doi.org/10.1016/S2665-9913(23)00037-1.