Generates a patient-specific, weight-based reduced-dose glucocorticoid taper with actual calendar dates, Athena-ready instructions, and optimized prednisone prescriptions — updated instantly as you type.
PEXIVAS randomized 704 patients with severe GPA/MPA to a reduced-dose vs. standard glucocorticoid regimen, cutting cumulative exposure ~40% over the first 6 months.
Serious infections at 1 year were significantly lower with the reduced-dose regimen (27.2% vs 33.0%) — the major driver of early treatment-related harm.
Reduced-dose was noninferior to standard dosing for the composite of death or ESKD, with comparable remission and relapse outcomes.
New-onset or relapsing severe ANCA-associated vasculitis (GPA/MPA) on induction therapy; UpToDate authors also consider it reasonable for EGPA. May begin immediately or after IV pulse glucocorticoids.
The taper displayed here follows the reduced-dose glucocorticoid regimen from PEXIVAS as reproduced by UpToDate with permission (Graphic 129362, v4.0).
Developed by Craig G. Hurwitz, MD · Northern Nephrology & Hypertension
Enter weight and the prednisone start date — everything below updates instantly.
Each segment is one published taper step. Hover, tap, or use arrow keys for dose, dates, and running cumulative exposure. Darker segments = higher dose.
The full taper as actual calendar dates. Consecutive weeks at the same dose are combined into a single interval.
Ready to paste directly into the Athena patient instructions field. Pick a format, then copy.
Minimum pill burden using 20 mg, 10 mg, and 5 mg tablets. Half-tablets are used only where a dose ends in 2.5 mg; 1 mg tablets are added only if the schedule requires a 6 mg dose.
Exactly what would be prescribed, one entry per tablet strength.
A clean, checkbox schedule the patient can keep on the fridge and mark at each dose change.
The regimen as published — all three weight columns, with your patient's column highlighted. Expand any row for dates and tablet breakdown. The final row shows the published week-52 course; your patient's schedule ends at the week selected above.
Evidence and practical guidance for running a reduced-dose taper safely.
Work through these at taper initiation. Checks persist while this page stays open.
High burden early, rapid de-escalation, then a long low-dose plateau. Hover or tap the chart for week-by-week totals.
The one-glance version for your note.
NNH Interactive · ANCA Reduced-Dose Prednisone Taper v1.1 · Clinical decision support, not a substitute for clinical judgment.
