Glucocorticoid withdrawal and glucocorticoid-induced adrenal insufficiency: Study protocol of the randomized controlled «TOASST" (Taper Or Abrupt Steroid STop) multicenter trial.

Publication

Journal Paper/Review - Apr 5, 2023

Komminoth Mathis, Donath Marc Y, Hepprich Matthias, Schuetz Philipp, Blum Claudine A, Müller-Stich Beat P, Reny Jean-Luc, Gosselin Pauline, Breville Gautier, Brändle Michael, Henzen Christophe, Leuppi Joerg Daniel, Kistler Andreas D, Thurnheer Robert, Beuschlein Felix, Rudofsky Gottfried, Aeberli Daniel, Villiger Peter M, Böhm Stephan, Chifu Irina, Fassnacht Martin, Meyer Gesine, Bojunga Jörg, Cattaneo Marco, Sluka Constantin, Schneider Helga, Rutishauser Jonas, «TOASST» study group

Citation

Komminoth M, Donath M, Hepprich M, Schuetz P, Blum C, Müller-Stich B, Reny J, Gosselin P, Breville G, Brändle M, Henzen C, Leuppi J, Kistler A, Thurnheer R, Beuschlein F, Rudofsky G, Aeberli D, Villiger P, Böhm S, Chifu I, Fassnacht M, Meyer G, Bojunga J, Cattaneo M, Sluka C, Schneider H, Rutishauser J, «TOASST» study group. Glucocorticoid withdrawal and glucocorticoid-induced adrenal insufficiency: Study protocol of the randomized controlled «TOASST" (Taper Or Abrupt Steroid STop) multicenter trial. PloS one 2023; 18:e0281585.

Type

Journal Paper/Review (English)

Journal

PloS one 2023; 18

Publication Date

Apr 5, 2023

Issn Electronic

1932-6203

Pages

e0281585

Brief description/objective

Despite the widespread use of glucocorticoids in inflammatory and autoimmune disorders, there is uncertainty about the safe cessation of long-term systemic treatment, as data from prospective trials are largely missing. Due to potential disease relapse or glucocorticoid-induced hypocortisolism, the drug is often tapered to sub-physiological doses rather than stopped when the underlying disease is clinically stable, increasing the cumulative drug exposure. Conversely, the duration of exposure to glucocorticoids should be minimized to lower the risk of side effects.