Evaluation of the toxicity of glucocorticoids in patients with autoimmune blistering disease using the Glucocorticoid Toxicity Index: A cohort study

• Published in: JAAD international Vol. 6; pp. 68 - 76
• Main Authors: Liang, Yicong, Zeng, Faith A.P., Sheriff, Tabrez, Wilson, Anna, Bilgic, Asli, Feng, Grant, Stone, John H., Murrell, Dedee F.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2022; Elsevier
• Subjects: Autoimmune blistering disease; clinical research; Dermatology; glucocorticoid; Glucocorticoid Toxicity Index; Original; side effect; side effect; GCAE; GTI-AIS; Glucocorticoid Toxicity Index; glucocorticoid; AIBD; Autoimmune blistering disease; clinical research; GTI-CWS; GTI; ABQOL; BMI; body mass index; Glucocorticoid Toxicity Index Aggregate Improvement Score; Autoimmune Bullous Disease Quality of Life; Glucocorticoid Toxicity Index Cumulative Worsening Score; glucocorticoid-induced adverse effect; BMI, body mass index; ABQOL, Autoimmune Bullous Disease Quality of Life; GTI-CWS, Glucocorticoid Toxicity Index Cumulative Worsening Score; GTI-AIS, Glucocorticoid Toxicity Index Aggregate Improvement Score; AIBD, autoimmune blistering disease; GCAE, glucocorticoid-induced adverse effect; GTI, Glucocorticoid Toxicity Index
• ISSN: 2666-3287; 2666-3287
• DOI: 10.1016/j.jdin.2021.09.003

Glucocorticoids are the mainstay of treatment for autoimmune blistering diseases (AIBDs). The Glucocorticoid Toxicity Index (GTI) is a novel, outcome-based glucocorticoid-induced adverse effects monitoring instrument. To investigate whether the GTI score was able to accurately quantify the glucocorticoid-induced toxicity in patients with AIBDs. The prospective cohort study included patients with confirmed diagnoses of AIBDs (group1, currently receiving glucocorticoids; and group 2, had glucocorticoids ceased earlier). Data were collected minimally at baseline (V1) and 3 months (V2). Further data from patients who were able to complete the follow-up visits at 6 months (V3) and 12 months (V4) amid the COVID-19 pandemic were also included. GTI scores were calculated after data collection. Analysis of data from V1 and V2 found a linear correlation between GTI score and prednisone doses (P < .05) and a significant difference in GTI scores between group1 and group 2 (P < .05). Data from V3 and V4 suggested that GTI scores continued to rise progressively alongside increasing cumulative prednisone dose. Small sample size, further exacerbated by the COVID-19 pandemic. Single-center study. The GTI sensitively and specifically captured the changes in glucocorticoids toxicity over time among patients with AIBDs. The GTI could be a feasible tool that can be used in future clinical trials as a glucocorticoid-induced toxicity outcome measure.