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While European and Endocrine Society guidance outlines tapering strategies, limited data exist on real-world implementation across specialties. An anonymous online survey assessed how endocrine and non-endocrine clinicians wean patients off long-term prednisolone, capturing approaches, switching practices, referral patterns, and barriers. Results show heterogeneous discontinuation practices and frequent relapse-related barriers.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/weaning-patients-off-long-term-prednisolone-a-survey-of-physicians-practice-in-the-uk-and-southeast-asia/439274/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/weaning-patients-off-long-term-prednisolone-a-survey-of-physicians-practice-in-the-uk-and-southeast-asia/439274.png","ImageObject",300,407,{"name":92,"@type":93},"Maya Linwood","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",14,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What was the study’s primary objective?","Question",{"text":113,"@type":114},"To determine how glucocorticoids are weaned in patients by endocrine and non-endocrine specialists, including barriers and challenges to GC tapering.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How were participants recruited and what was the study design?",{"text":118,"@type":114},"Anonymous online surveys were distributed to members of endocrine societies in the UK and Southeast Asia, with non-endocrine specialists surveyed in the UK and Singapore.",{"name":120,"@type":111,"acceptedAnswer":121},"What were the main barriers to glucocorticoid weaning reported by clinicians?",{"text":122,"@type":114},"Relapse of the underlying condition was the most common barrier, reported by both endocrine and non-endocrine respondents.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},439274,1791027855,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},962084928432,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Open access Original research  \nTo cite: Lazarus K, Eng PC, Narula K, et al. Weaning patients off long-term prednisolone: a survey of physicians’ practice in the UK and Southeast Asia. BMJ Open 2025;15:e107269 . doi:10 . 1136/ bmjopen-2025-107269  \n► Prepublication history and additional supplemental material for this paper are available online. To view these files, please visit the journal online ([https://doi.org/10.1136/](https://doi.org/10.1136/)[ ](https://doi.org/10.1136/)[bmjopen-2025-107269](bmjopen-2025-107269)) .  \nReceived 30 June 2025 Accepted 18 November 2025  \n© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY.  \nPublished by BMJ Group. 1Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK 2Department of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK  \n3Department of Endocrinology, National University Hospital, Singapore  \nCorrespondence to  \nDr Karim Meeran;  \n[k.meeran@imperial.ac.uk](k.meeran@imperial.ac.uk)  \nWeaning patients off long-term prednisolone: a survey of physicians’practice in the UK and Southeast Asia  \nKatharine Lazarus  ,1,2 Pei Chia Eng  ,2,3 Kavita Narula  ,1  \nAngelica Sharma,1,2 Sirazum Choudhury  ,1,2 Deborah Papadopoulou  ,1 Niamh M Martin  ,1,2 Florian Wernig,1,2 Tricia Tan  ,1,2 Karim Meeran  1,2  \nABSTRACT  \nStudy objective Prolonged glucocorticoid (GC) use is associated with significant morbidity and mortality, including the development of GC induced adrenal insufficiency. Recent guidance from the European Society of Endocrinology and Endocrine Society provides a framework for tapering GCs. However, there is limited understanding of current practice across endocrine and other medical specialties, including barriers and challenges to GC weaning. This study aimed to establish how GCs are weaned in patients across endocrine and non-endocrine specialists.  \nDesign and setting Anonymous online surveys  \nwere disseminated to all members of the Society for Endocrinology and all members of the Association of Southeast Asian Nations Federation of Endocrine Societies and the Endocrine and Metabolic Society of Singapore. Non-endocrine specialists were surveyed in the UK and in Singapore.  \nResults A total of 306 (258 endocrine specialists and 48 non-endocrine specialists) responded to the survey. Approaches to discontinuing prednisolone were heterogeneous. Among endocrine respondents, only 78% would fully wean the prednisolone, with 50.4% switching to hydrocortisone to wean and 12.6% favouring longterm GC replacement without further investigations. Among the non-endocrine respondents, 16.7% would stop prednisolone abruptly and 10.4% would refer to endocrinology to supervise weaning. The most common barrier to weaning GCs reported by both endocrine and non-endocrine specialists was relapse of the underlying condition (55 .9% and 70 .8%, respectively) .  \nConclusions Relapse of the underlying condition is common, and endocrinology input may not be appropriate when this occurs. There remains a need to develop an evidence-based approach for safe and effective  \nGC weaning and hypothalamic–pituitary–adrenal axis assessment.  \nINTRODUCTION  \nProlonged use of glucocorticoid (GC), even at low doses (eg, prednisolone 5 mg daily) is associated with significant adverse outcomes, including increased morbidity and mortality.1 These risks include an increased risk of osteoporosis,2 diabetes, cardiovascular disease,  \nSTRENGTHS AND LIMITATIONS OF THIS STUDY   \n⇒ A web-based survey capturing glucocorticoid (GC) weaning practices among endocrine and nonendocrine specialists in the UK and Southeast Asia.  \n⇒ Limitations include the respondent time frame of 3 months and design of the survey in English, which may have limited participation.  \n⇒ The design of the survey relied on self-reported data, which may be subject to recall bias.  \n⇒ The survey explores real-world barriers to GC weaning, which will inform the design of larger prospective ","cbCaitSc5FzbAhBS","https://ap.wps.com/l/cbCaitSc5FzbAhBS","pdf",1721123,"English","# ABSTRACT\n## Study objective\n## Design and setting\n## Results\n## Conclusions\n# INTRODUCTION\n# STRENGTHS AND LIMITATIONS OF THIS STUDY","[{\"question\":\"What was the study’s primary objective?\",\"answer\":\"To determine how glucocorticoids are weaned in patients by endocrine and non-endocrine specialists, including barriers and challenges to GC tapering.\"},{\"question\":\"How were participants recruited and what was the study design?\",\"answer\":\"Anonymous online surveys were distributed to members of endocrine societies in the UK and Southeast Asia, with non-endocrine specialists surveyed in the UK and Singapore.\"},{\"question\":\"What were the main barriers to glucocorticoid weaning reported by clinicians?\",\"answer\":\"Relapse of the underlying condition was the most common barrier, reported by both endocrine and non-endocrine respondents.\"}]","Weaning patients off long-term prednisolone - a survey of physicians’ practice in the UK and Southeast Asia | PDF",1790688035,18]