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Hypothesis 1: A reduction in side effects is achieved with monitoring glucocorticoid treatment by using the Glucocorticoid Toxicity Index (GTI) in patients using glucocorticoids.
Hypothesis 2: Monitoring treatment by using GTI in patients using glucocorticoids causes a decrease in glucocorticoid toxicity and an increase in the quality of life of patients.
Hypothesis 3: With the involvement of the clinical pharmacist in the multidisciplinary team in patients using glucocorticoids, the drug-related problems of the patients are detected and prevented.
The aim of this study was to evaluate the glucocorticoid treatment of patients with RA, SLE and vasculitis treated with glucocorticoids prospectively by a multidisciplinary team with GTI. In addition, it was aimed to identify and prevent drug-related problems by reviewing all drugs used in these patients by the clinical pharmacist.
In this study, the side effects of glucocorticoids used by patients will be evaluated using the Glucocorticoid Toxicity Index (GTI) index. This index includes areas for commonly recognized adverse events as a result of cumulative steroid exposure. It is weighted and measures both worsening and improvement. Scores range from -346 to 439 with cumulative worsening score relating to an increase in GC toxicity burden. "-" points indicate improvement, "+" points indicate worsening. The higher the patient's burden of glucocorticoid toxicity, the higher his score.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| RA, SLE, and vasculitis patients who have just started glucocorticoid treatment | |||
| RA, SLE and vasculitis patients receiving glucocorticoid treatment for the last 2 years |
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| Measure | Description | Time Frame |
|---|---|---|
| change in Glucocorticoid Toxicity Index (GTI) scores | In this study, it is predicted that a change in GTI scores will be achieved during 3-month follow-up in patients with long-term and newly diagnosed RA, SLE and vasculitis. When the 6-month follow-up of each patient is completed, the study will be terminated. In this study, the side effects of glucocorticoids used by patients will be evaluated using the Glucocorticoid Toxicity Index (GTI) index. This index includes areas for commonly recognized adverse events as a result of cumulative steroid exposure. It is weighted and measures both worsening and improvement. Scores range from -346 to 439 with cumulative worsening score relating to an increase in GC toxicity burden. "-" points indicate improvement, "+" points indicate worsening. The higher the patient's burden of glucocorticoid toxicity, the higher his score. | Each patient will be followed up for a total of 6 months, at 3 and 6 months. |
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Inclusion Criteria:
Exclusion Criteria:
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Patients with a diagnosis of RA, SLE or vasculitis followed in the Hacettepe University Hospitals Rheumatology Outpatient Clinic and receiving glucocortioid therapy will be included in the study.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Melda Bahap, master of science | Contact | +905398979922 | melda_610@hotmail.com | |
| Emine Duran, md | Contact | +905372103145 | docemineduran@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Omer Karadag, prof. doctor | Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hacettepe University | Recruiting | Ankara | 06100 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38781534 | Derived | Bahap-Kara M, Sariyildiz E, Zengin HY, Karadag O, Bayraktar-Ekincioglu A. Prospective assessment of glucocorticoid toxicity in rheumatology practice: a focus on the glucocorticoid toxicity index. Rheumatology (Oxford). 2025 Mar 1;64(3):1010-1018. doi: 10.1093/rheumatology/keae288. |
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| ID | Term |
|---|---|
| D001172 | Arthritis, Rheumatoid |
| D014657 | Vasculitis |
| D008180 | Lupus Erythematosus, Systemic |
| ID | Term |
|---|---|
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
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| D003240 |
| Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |