[When and how to withdraw glucocorticoid therapy in elderly?]

Glucocorticoid therapy (GCT) is commonly used for the treatment of many chronic diseases. It is prescribed in almost 3% of the population > or = 70-years-old. Numerous short- and long-term side effects can occur even at low doses. GCT should be preceded by screening for and stabilization of disorders that can be aggravated by treatment. During GCT regular monitoring for side effects, adjusting of the treatment to the lowest effective dose and regular re-evaluation of the indication are required. The GC withdrawal protocols are not evidence-based and are chosen essentially according to the risk of reactivation of the treated disorder. The risk of secondary adrenal insufficiency is real but quite low, and does not in itself justify the continuation of a GCT.