The Role of Quantification of Glucocorticoid-associated Toxicity in Severe Asthma.

Until recently, oral glucocorticoid (GC) therapies were the mainstay of treatment for uncontrolled inflammatory disease across many body systems. The last 30 years, however, have witnessed a transformation in the management of many diseases due to the development of targeted biological agents leading to a reduction, albeit not a removal, of the dependence on oral GCs. The need for new glucocorticoid-sparing therapies was urgent given the ever increasing and robust literature on the multisystem adverse effects related to chronic or repeated oral GC exposures [1–6]. The importance of measuring the potential GC-toxicity reduction by “steroid-sparing” agents — and the absence of a validated tool with which to accomplish this goal — was recognised by a group of international investigators from a broad range of medical specialities. These investigators developed and validated such a tool, the Glucocorticoid Toxicity Index (GTI) [7].