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The Patients' Perspective of Important Glucocorticoid Effects: A Nominal Group Study Among Patients With Systemic Lupus Erythematosus and Myositis.

  • Mirza, Serene Z
  • Cheah, Jonathan T L1
  • Ghosh, Nilasha1
  • Robson, Joanna C2
  • Hill, Catherine L3
  • Singh, Jasvinder4
  • Mackie, Sarah L5
  • Navarro-Millán, Iris
  • Simon, Lee S6
  • Goodman, Susan M1
  • 1 From the Hospital for Special Surgery.
  • 2 University of the West of England and School of Clinical Science, Bristol, United Kingdom. , (United Kingdom)
  • 3 Royal Adelaide Hospital at University of Adelaide, Adelaide, Australia. , (Australia)
  • 4 University of Alabama Medical Center, Birmingham, AL.
  • 5 Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom. , (United Kingdom)
  • 6 SDG LLC, New York, NY.
Published Article
Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases
Publication Date
Sep 01, 2021
DOI: 10.1097/RHU.0000000000001313
PMID: 31985721


The objective of this cohort study was to understand the positive and negative effects of glucocorticoids (GCs) in patients with systemic lupus erythematosus and myositis from the patients' perspective with the aim of developing a patient-reported outcome measure. Included patients were asked to participate in 1 of 5 nominal groups where demographic information and a quality-of-life questionnaire were collected. Patients were asked 2 open-ended questions on (1) benefits and (2) harms related to GC use. We used the Nominal Group Technique, a highly structured consensus method in which responses are generated, shared, and ranked. Descriptive statistics were used to summarize the results. Nominal group sessions took place from April to May 2019. Of 206 patients who were approached, 21 patients participated, 17 with systemic lupus erythematosus and 4 with myositis, predominantly women with more than 10 years of steroid use. The domains ranked highest for GC benefits were disease control (55 votes), fast onset of action (30 votes), increased energy (10 votes), and pain relief (10 votes). The highest-ranked negative effects were bone loss (38 votes) and weight gain (16 votes); psychological effects and damaged internal organs each received 12 votes. The top-ranked GC effects-both benefits and harms-among patients with systemic rheumatic disease are consistent with the top domains associated with GC use reported with other inflammatory diseases. This study informs the development of a comprehensive patient-reported outcome measure that can be used across inflammatory diseases. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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