Is it necessary to prescribe a steroid taper after two weeks of high-dose prednisone (60 mg daily)?

Interesting question. Not being an endocrinologist, I don't have the expertise to advise but the reference below makes the statement that even short-term steroids can be an issue. I suspect that if you have to stop abruptly from 60 mg daily for 2 weeks, it would probably be fine in most instances bu...

The simple answer to this is "no" but I think for a bigger picture of when to taper and how to taper, here is a recent link by Brett et al., NEJM Journal Watch 2024.

The answer is no, with some caveats. I recommend reviewing the paper by Cardenas et al., PMID 36545644.

Of course, I agree with my colleagues.

But... for excellent reviews I must add the most recent open-access European Society of Endocrinology and Endocrine Society Joint Clinical Guidelines for Diagnosis and therapy of glucocorticoid-induced adrenal insufficiency by Beuschlein et al., PMID 38714321.

My 2 cents: Granted I take care of AYA cancer patients who are otherwise healthy.

I see a lot of high-dose steroid use/recommendations with long tapers for treating immune-related side effects from CPI drugs.

Besides the many side effects we are all aware of, steroids are associated with early relap...

I have appreciated the helpful responses to the question. One question I cant seem to find an answer to with all the great resources cited is how long does it take to suppress the HPA axis? I suspect it might be based on dose and formulation of CS. I have used the data from years ago that suggested ...