Introduction/Aims: Glucocorticoid (GC)- related adverse reactions and risks are commonly seen during the treatment of immune- mediated and inflammatory neuromuscular disorders. There is wide variation in the management of associated complications. The aim of this study is to develop international consensus guidance on the management of GC- related complications in neuromuscular disorders.

Methods: Through the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM), an international task force of 15 experts was convened to develop clinical guidance for the management of GC- related complications in neuromuscular patients. The RAND/UCLA appropriateness method (RAM) was used to develop consensus guidance statements. Initial guidance statements were crafted after a thorough literature review and were modified after anonymous panel input, with up to three rounds of voting via email to achieve consensus.

Results: Statements were developed and achieved consensus for general care, monitoring of patients while on GC, osteoporosis prevention, vaccinations, infection screening, and Pneumocystis jiroveci pneumonia prophylaxis. A multidisciplinary approach to the management of GC- related complications was emphasized.

Discussion: These formal consensus statements provide guidance to clinicians who use GC in the treatment of neuromuscular diseases regarding prevention and management of the more common associated adverse events and risks that arise with long and short- term GC use and serve as a springboard for investigation and updates.

引言/目的：
在免疫介导性和炎症性神经肌肉疾病的治疗中，糖皮质激素（GC）相关的不良反应和风险十分常见。然而，针对其相关并发症的管理存在很大差异。本研究旨在制定关于神经肌肉疾病中GC相关并发症管理的国际共识指南。

方法：
通过美国神经肌肉与电诊断医学协会（AANEM），召集了一个由15名专家组成的国际工作组，旨在为神经肌肉疾病患者的GC相关并发症管理制定临床指南。共识指南声明的制定采用了兰德/加州大学洛杉矶分校适当性方法（RAND/UCLA Appropriateness Method, RAM）。在完成详尽的文献综述后，起草了初步的指南声明；随后，通过匿名专家小组意见征询对声明进行了修改，并通过最多三轮电子邮件投票达成共识。

结果：
工作组制定并达成了共识的声明涵盖以下领域：常规护理、GC用药期间的患者监测、骨质疏松预防、疫苗接种、感染筛查以及耶氏肺孢子菌肺炎（Pneumocystis jiroveci pneumonia, PJP）的预防。指南强调采用多学科协作模式来管理GC相关并发症。

讨论：
这些正式的共识声明为在神经肌肉疾病治疗中使用GC的临床医生提供了指导，内容涉及预防和管理长期及短期使用GC时出现的更常见不良事件和风险。这些声明也为未来的研究探索和指南更新奠定了基础。