"The patient in front of the us sleeps poorly, is gaining weight, and has acne and hair on her face. Her bones are thinner. She has developed hypertension and is becoming diabetic. She is at a significantly increased risk of infections, such as zoster. But much of this happens slowly, and it’s never measured."
John H. Stone, MD MPH
Professor of Medicine,
Harvard Medical School
The Edward Fox Chair in Medicine,
Massachusetts General Hospital
"An African-American woman in her 40's with sarcoidosis who has already had a knee and shoulder replaced? There’s no doubt at all that it was related to corticosteroids."
Paul Brunetta, MD
Head of Clinical & Translational Science, Sana Biotechnology
Adjunct Associate Professor, Pulmonary and Critical Care Division,
University of California, San Francisco
“Yesterday in the clinic I saw a patient who has been on steroids for six years. Her doctor has never ordered a bone mineral density study! We have no idea whether this 37 year old woman has the bones of an 80 year old."
John H. Stone, MD MPH
Professor of Medicine,
Harvard Medical School
The Edward Fox Chair in Medicine,
Massachusetts General Hospital
“If you are a patient who has been using steroids for a long time, that becomes your life. When you have debilitating osteoporosis, debilitating diabetes, or cardiovascular disease due to steroid use, THAT becomes your disease. It’s not your underlying disease anymore. It's the steroid disease that you are dealing with.”
Pirow Bekker, MD PhD
Former Chief Medical Officer at ChemoCentryx
“Rheumatologists and practicing internists recognize that while we are able to control the disease we are left with the yin and yang of having to deal with all the side effects of glucocorticoid therapy.”
Sudhakar Sridharan, MD
Vice President, Global Product Development, Imm/Rheum/Inflam/Clinical Research
PPD/ThermoFisher
"I think that the problem of steroid-toxicity has been minimized for too long. For far too long."
Pirow Bekker, MD PhD
Former Chief Medical Officer at ChemoCentryx
"Optimal treatment of sarcoidosis involves not only minimizing the effects of granulomatous inflammation but minimizing the side effects of corticosteroids. Therefore, monitoring sarcoidosis patients for glucocorticoid toxicity is a cornerstone of therapy"
Marc Judson, MD
Professor of Medicine,
Chief of the Division of Pulmonary and Critical Care Medicine,
Albany Medical College
"In neuroimmunological diseases, we are keenly aware of the long term damage from chronic corticosteroid use and have been moving to steroid-sparing therapies over the past 10 years. For our patients, the benefits from weaning off corticosteroids feels to them like we are moving in the right direction."
Michael Levy MD PhD
Associate Professor, Harvard Medical School
Director, Neuroimmunology Clinic and Research Laboratory
Research Director, Division of Neuroimmunology & Neuroinfectious Disease
Department of Neurology, Massachusetts General Hospital
Tagore said, “let him only see the thorns who has eyes to see the rose.” In a patient with long-term glucocorticoid treatment, physicians must keep an eye on “thorny” toxicities as much as on the disease they seek to treat. Glucose intolerance, dyslipidemia, osteoporosis, infection are but a few of dozens of steroid side effects.
Wen Zhang, MD PhD
Professor of Medicine
Vice Director, Department of Rheumatology
Peking Union Medical College Hospital
"For too long our singular goal as physicians has been focused on disease treatment without consideration to glucocorticoid treatment toxicity. In the era of medical advancement and drug discovery, now is the time to understand and quantify the burden of toxicity related to glucocorticoid treatment and understand its true short- and long-term costs."
Neelam Goyal, MD
Clinical Associate Professor of Neurology,
Neuromuscular Medicine,
Stanford Neuroscience Health Center
