At each visit, write down the current daily dose of prednisolone or equivalent, the dose a year ago, and the target dose with a date. If disease control allows, reduce stepwise towards the lowest dose that holds the disease quiet, and consider a steroid-sparing agent early.
Doing this at every visit makes drift visible, which a single prescription list does not.
- Record the current dose, the dose a year ago and a dated target.
- Taper stepwise when disease is controlled, and document the reasoning.
- Consider a steroid-sparing agent early rather than as a late option.
- Check bone, glucose, blood pressure and lipids on a schedule.
Why it matters
Small daily doses accumulate unnoticed across years of follow-up.
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