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):
- ANCA Associated Vasculitis,
- Asthma,
- Autoimmune Bullous Dermatosis,
- Bullous Pemphigoid,
- Cardiac Sarcoidosis,
- Congenital Adrenal Hyperplasia,
- Giant Cell Arteritis (GCA),
- Sarcoidosis,
- Granulomatosis with Polyangiitis (GPA),
- Idiopathic Inflammatory Myopathies,
- Inflammatory Rheumatism,
- Juvenile idiopathic arthritis,
- Lupus Nephritis,
- Microscopic Polyangiitis (MPA),
- Minimal Change Disease, Nephrotic Syndrome,
- Pemphigus,
- Pemphigus Foliaceus,
- Pemphigus Vulgaris,
- Polymyalgia Rheumatica (PMR),
- Rheumatoid Arthritis,
- Systemic Autoimmune Disease,
- Systemic Lupus Erythematosus (SLE),
- Vasculitis.
References
- 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.
- 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.