Safely Withdrawing Glucocorticoid Therapy: A Case-Based Approach
Bibliographic record
Abstract
Abstract Glucocorticoids (GCs) have potent anti-inflammatory and immunomodulating effects, making them effective for treating various diseases. They are among the most commonly prescribed medications worldwide. The prevalence of GC therapy in the general population is estimated to be ∼0.9 to 3%, though it is challenging to determine precisely. The chronic GC therapy is associated with severe morbidity and increased mortality due to iatrogenic Cushing's syndrome and suppression of the hypothalamic–pituitary–adrenal axis, leading to tertiary adrenal insufficiency. Therefore, it is not recommended to abruptly stop chronic GC therapy, and a gradual tapering of GCs is generally considered the ideal approach for GCs withdrawal. However, withdrawing GCs in patients on chronic therapy can be challenging due to the difficulty in accurately assessing HPA function. In this article, we aim to provide a practical, case-based approach to GC withdrawal based on current literature and our extensive experience in this field.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".