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Many patients have suppression of the pituitary-adrenal axis after long-term corticosteroid therapy is stopped. French researchers conducted this retrospective study to examine the effect of cumulative dose and duration of steroid therapy on risk for adrenal insufficiency after stopping steroids.
Sixty patients, most with autoimmune diseases or vasculitides, had been taking 5 mg to 10 mg (mean, 7 mg) of prednisone daily when short cosyntropin stimulation tests were performed. Cumulative doses of prednisone ranged from 1 g to 132 g, and total duration of exposure ranged from 4 months to 32 years. Stimulation testing was normal in 51% of patients and abnormal in 49%. The authors' criterion for abnormal testing was either unstimulated baseline …