A structured approach to address variability in the global management of adrenal insufficiency in Duchenne muscular dystrophy: the 2025 PJ Nicholoff steroid protocol - Takeaways - MDSpire
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A Comprehensive Framework for Managing Variability in Adrenal Insufficiency Treatment in Duchenne Muscular Dystrophy: The 2025 PJ Nicholoff Steroid Guidelines

  • By

  • Anne Marie Sbrocchi

  • Alexandra Ahmet

  • Kathi Kinnett

  • Maria-Elena Lautatzis

  • Hugh J. McMillan

  • Susan Apkon

  • Meilan M. Rutter

  • Leanne M. Ward

  • Sasigarn A. Bowden

  • Anne M. Connolly

  • Garey Noritz

  • Rachel Schrader

  • Kathryn Selby

  • Aravindhan Veerapandiyan

  • Sze Choong Wong

  • David R. Weber

  • September 10, 2026

Share

  • 1

    Chronic glucocorticoid therapy in Duchenne muscular dystrophy can lead to adrenal suppression and increase the risk of adrenal crisis.

  • 2

    The 2025 PJ Nicholoff Steroid Protocol provides a structured framework for managing adrenal suppression in individuals with DMD.

  • 3

    Variability in glucocorticoid treatment regimens for DMD exists globally due to differences in drug availability and clinician preferences.

  • 4

    Vamorolone, a newer treatment, selectively modulates glucocorticoid receptor activity, potentially reducing adverse effects associated with classic glucocorticoids.

  • 5

    Effective management of adrenal suppression requires anticipatory education, stress-steroid plans, and careful transitions between glucocorticoid agents.

Original Source(s)

A structured approach to address variability in the global management of adrenal insufficiency in Duchenne muscular dystrophy: the 2025 PJ Nicholoff steroid protocol

  • by Anne Marie Sbrocchi, Alexandra Ahmet, Kathi Kinnett, Maria-Elena Lautatzis, Hugh J. McMillan, Susan Apkon, Meilan M. Rutter, Leanne M. Ward, Sasigarn A. Bowden, Anne M. Connolly, Garey Noritz, Rachel Schrader, Kathryn Selby, Aravindhan Veerapandiyan, Sze Choong Wong, David R. Weber

  • September 10, 2026

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