Within days of the first use of cortisone in 1948, doctors recognized the need to find the lowest therapeutic dose to manage disease and eliminate steroid toxicity. Over the next 75 years, progress in tapering glucocorticoid use was slow, due largely to the lack of: effective alternatives, consensus among practitioners on what to measure, and technology to make measurement practical, if even possible.

To confront this problem head on Steritas launched The Great Taper^TM  —  a public initiative to accelerate a shift in steroid prescribing patterns worldwide.  

In service of this movement, we built:

• The STOX Suite to measure steroid-toxicity
• The STOX Digital Platform to validate results
• Steroids and Me (Sam) to strengthen the doctor-patient connection

This body of work establishes an essential framework to step up The Great Taper and put the burdens of steroid-toxicity behind us for good.

In our mission to alleviate the heavy burdens of steroid-toxicity, Steritas established the STOX Suite, a selection of world-class clinical outcome assessment (COA) tools for measuring steroid-toxicity.

We collaborate across all subspecialties to provide the most effective solutions for use in:

• Clinical research for development of new steroid-sparing drugs and treatment protocols
• Health and economics outcomes research (HEOR) for discovery of steroid-toxicity and hidden costs found in large datasets
• Routine practice to monitor emerging steroid-toxicity in clinic patients
• Direct-to-patient applications that help patients collaborate in their treatment

The Steritas STOX Suite (GTI, GTI-MD, and pGTI) has been used in over 75+ clinical trials, in 1100 sites across 80 countries.

Over 80 steroid-toxicities are on record, ranging from inconvenient to life-threatening. In pediatric illnesses, steroids are especially cruel and persist into adulthood – affecting growth and disrupting the psychosocial development of our children.

To learn more about the range of side effects, watch the video.

At first glance, steroids appear less costly than other inflammatory disease medications, but research continues to reveal that the true economic impact of steroid use is staggering.

A study revealed that the adverse effects of glucocorticoids accounted for 40% of medical costs for patients taking glucocorticoids in high doses or for longer than 60 days, for a range of autoimmune and inflammatory diseases. Strikingly, only 25% of their medical costs were disease related.^[1]

A second study of systemic lupus erythematosus patients reported that high-dose glucocorticoid users were 30% more likely to have emergency room visits, 80% more likely to be hospitalized, and incurred about three times greater average annual total healthcare costs as compared to low-dose glucocorticoid users.^[2]

A third longitudinal study of severe asthma demonstrates that steroid-toxicity at year one predicts steroid-toxicity at year three, even in the face of reduced exposure to steroids. These findings suggest that alternatives are introduced too late.^[3]

The STOX Suite is at the center of all efforts to:

• Quantify the impact of steroid-toxicity on patients
• Make evidence-based calculations of the burden on populations
• Validate results to reduce healthcare costs

More work is underway in economic disutility, fiscal modeling and societal fiscal value of steroids and steroid alternatives.  We expect the STOX Suite to be a pivotal component of the most rigorous analysis in these areas.