What is your approach to tapering chronic steroids in patients who are at high risk of HPA suppression?
For example, patients who have been maintained on 5mg of prednisone for years without previous tapering attempts and the rheumatic disease is not active. Do some patients develop a permanent HPA suppression and can never be tapered?
Answer from: at Community Practice
There are rare cases when the adrenal function never seems to recover. The ACTH recovery happens before cortisol so that it can be monitored as a marker.
When I get a consult about tapering GCs in a patient on long-term therapy, I usually let the primary team (e.g., rheumatologist) cut back on pred...
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