Is there a safe and effective way to wean patients off long-term glucocorticoids?
Long term systemic glucocorticoid treatment can be defined as continuous treatment for more than 3 weeks. Long term glucocorticoids must be withdrawn slowly to prevent loss of disease control and manage end-of-use adverse reactions. This is usually done using a tapering regimen, an example used for patients with inflammatory rheumatic diseases is shown in table 2 [24]. This section discusses practical approaches to weaning patients off long term glucocorticoids that can help to minimise harms from loss of disease control and end-of-use adverse effects. These approaches are illustrated through discussion of 3 clinical cases shown in boxes 1-3.