POMC and Adrenal insufficiency: In the PONENTE study, no OCS dose optimization phase was included, likely due to the open-label design; however, the OCS dose reduction phase had an initial target of 5 mg/day, with further dose reductions of 2.5 mg/day permitted for patients with no adrenal insufficiency, assessed by adrenocorticotropic hormone stimulation testing (Fig. 1a) [24].