A structured approach to address variability in the global management of adrenal insufficiency in Duchenne muscular dystrophy: the 2025 PJ Nicholoff steroid protocol. (PubMed, Front Neurol) - Sep 26, 2026 - "Management is increasingly complex because DMD treatment now includes multiple GC agents, including prednisone/prednisolone, deflazacort, and vamorolone, as well as daily, intermittent, and transition regimens that differ across countries and clinical settings. The updated protocol incorporates newer therapies such as vamorolone and emphasizes anticipatory education, written stress-steroid plans (including a weight-based approach), safe GC tapering, confirmation of hypothalamic-pituitary-adrenal axis recovery, and careful management of transitions between GC agents and regimens. This structured approach aims to support safer and more consistent adrenal suppression management for individuals with DMD receiving chronic GC therapy through six critical concepts."
Journal • Review • Duchenne Muscular Dystrophy • Endocrine Disorders • Genetic Disorders • Muscular Dystrophy • Nephrology • Renal Disease
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Alexandra Ahmet; Anne M Connolly; Anne Marie Sbrocchi; Aravindhan Veerapandiyan; David R Weber; Garey Noritz; Hugh J McMillan; Kathi Kinnett; Kathryn Selby; Leanne M Ward; Maria-Elena Lautatzis; Meilan M Rutter; Rachel Schrader; Sasigarn A Bowden; Susan Apkon; Sze Choong Wong
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