The Glucocorticoid Toxicity Index (GTI) is intended to be a comprehensive instrument for assessing the toxicity associated with glucocorticoids. It was developed at multiple institutions in North America and Europe.
Parameters:
(1) body mass index (BMI)
(2) glucose tolerance
(3) blood pressure
(4) lipids
(5) bone density
(6) steroid myopathy
(7) skin toxicity
(8) neuropsychiatric toxicity
(9) infection
Parameter
Finding
Points
body mass index
improvement (weight loss)
-8
no change
0
moderate increase
21
major increase
36
glucose tolerance
improvement
-8
no change
0
worsening
32
worsening despite therapy
44
blood pressure
improvement
-10
no change
0
worsening
19
worsening despite therapy
44
lipids
improvement
-9
no change
0
worsening
10
worsening despite therapy
30
bone density
improvement
-1
no change
0
decrease
29
steroid myopathy
none
0
mild
9
moderate or severe
63
skin toxicity
none
0
mild
8
moderate or severe
16
neuropsychiatric toxicity
none
0
mild
11
moderate or severe
74
infection
none significant
0
mucosal candidiasis or uncomplicated zoster
19
Grade III infection or greater
93
total score =
= SUM(points for all 9 parameters)
Interpretation:
• minimum score: -36
• maximum score: 429 (439 in document)
• The higher the score the worse the impact of glucocorticoid therapy.
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