2605.02688 ADRENAL-TAPER: Glucocorticoid-Induced Adrenal Insufficiency and Crisis Risk-Context Stratification During Steroid Tapering in Autoimmune Disease
Chronic glucocorticoid therapy can suppress the hypothalamic-pituitary-adrenal axis, but clinicians need a transparent way to distinguish routine taper discomfort from clinically meaningful adrenal-insufficiency and adrenal-crisis risk. ADRENAL-TAPER integrates current prednisone-equivalent dose, exposure duration, taper speed, abrupt cessation, long-acting steroid exposure, morning cortisol, ACTH stimulation peak cortisol, symptoms, and physiologic stressors to produce a composite suppression/crisis score with a 95% uncertainty interval.