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Found 1 result for Related Articles by Review for PMID: 39541482
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Review

Methods for corticosteroid withdrawal: Adrenal insufficiency: identification and management

No authors listed
London: National Institute for Health and Care Excellence (NICE); 2024 Aug.
NICE Evidence Reviews Collection.
Free Books & Documents
Review

Methods for corticosteroid withdrawal: Adrenal insufficiency: identification and management

No authors listed.
Free Books & Documents

Excerpt

Exogenous glucocorticoids are used for their anti-inflammatory and immunosuppressive properties across many conditions ranging from asthma, inflammatory bowel disease, polymyalgia rheumatica and organ transplantation.

Mild symptoms during withdrawal of exogenous glucocorticoids are an expected and common occurrence and generally do not indicate unmasked adrenal insufficiency. However, if there is underlying adrenal insufficiency, either owing to adrenal suppression or because of medication use or intrinsic pituitary/adrenal disease it is potentially life-threatening. The risk of adrenal suppression depends on the dose and duration of the exogenous steroid therapy, as well as individual factors.

Current practice is very variable. Some clinicians gradually reduce the exogenous glucocorticoid dose over months, to a lower than physiological dose, and then provided that the patient feels well on the low daily dose this is simply stopped. Other clinicians will perform testing to check for adequate adrenal function before stopping glucocorticoids.

This evidence review considers what is the best way to manage glucocorticoid withdrawal when glucocorticoids are no longer needed to control underlying disease activity.

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