Table 1

The Glucocorticoid Toxicity Index

Composite GTIItem weightSpecific List
 Improvement in BMI–8Major increase in BMI
 No change in BMI0
 Moderate increase in BMI21
 Major increase in BMI36
Glucose tolerance
 Improvement in glucose tolerance–8Diabetic retinopathy
 No change in glucose tolerance0Diabetic nephropathy
 Worsening of glucose tolerance32Diabetic neuropathy
 Worsening of glucose tolerance despite treatment44
Blood pressure
 Improvement in blood pressure−10Hypertensive emergency
 No change in blood pressure0Posterior reversible encephalopathy syndrome
 Worsening hypertension19
 Worsening hypertension despite treatment44
 Improvement in lipids−9
 No change in lipids0
 Worsening hyperlipidaemia10
 Worsening hyperlipidaemia despite treatment30
Bone density
 Improvement in bone density−1Major decrease in bone density
 No change in bone density0Insufficiency fracture
 Decrease in bone density29
Steroid myopathy
 No steroid myopathy0Severe steroid myopathy
 Mild steroid myopathy9
 Moderate steroid myopathy or greater63
Skin toxicity
 No skin toxicity0Severe skin toxicity
 Mild skin toxicity8
 Moderate skin toxicity or greater26
Neuropsychiatric toxicity
 No neuropsychiatric symptoms0Psychosis
 Mild neuropsychiatric symptoms11GC-induced violence
 Moderate neuropsychiatric symptoms or greater74Other severe neuropsychiatric symptoms
 No significant infection0Grade IV infection
 Oral/vaginal candidiasis or uncomplicated zoster19Grade V infection
 Grade III infection or greater93
EndocrineAdrenal insufficiency
Peptic ulcer disease
MusculoskeletalAvascular necrosis
Tendon rupture
OcularCentral serous retinopathy
Intraocular pressure elevation
Posterior subcapsular cataract
Total−36 to 439
  • BMI, body mass index; GC, glucocorticoid; GTI, Glucocorticoid Toxicity Index.