Glucocorticoid-induced adrenal suppression: physiological basis and strategies for glucocorticoid weaning

To the Editor: The article by Torpy and Lim clearly describes the considerations required when developing a corticosteroid tapering regimen, including the potential for an increase in underlying disease activity. In neurological disorders, re-emergent disease activity can be life-threatening. Trials have previously been conducted that inform steroid dosing regimens in selected neurological conditions. However, significant practice variation remains. While existing trials inform practice in selected situations, there is a need for pragmatic randomised trials or to leverage large observational registry data to inform steroid usage in neurology...