How do you taper corticotropin injections (Acthar) in patients with rheumatologic disease?  

All rheumatologists will at some point in their career have a patient or two or three who do not tolerate any of the usually available steroids (po prednisone, po methylprednisolone, triamcinolone IM, IM methylprednisolone/dexamethasone, IV methylprednisolone) and who have ongoing active inflammator...

I typically start having them reduce dose by 1/4 of their standard dose every 2 weeks and then stop