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Similar biological effect of high-dose oral versus intravenous methylprednisolone in multiple sclerosis relapses

L Grau-López1, A Teniente-Serra2, M Tintoré3

  • 1Hospital Germans Trias i Pujol, Badalona, Spain/Universitat Autònoma de Barcelona, Spain laiagrlo@yahoo.es.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|August 23, 2014
PubMed
Abstract

Insights

Oral methylprednisolone (oMP) is as effective as intravenous methylprednisolone (ivMP) for treating multiple sclerosis (MS) relapses. Both treatments significantly reduced key inflammatory cytokines, demonstrating comparable efficacy in immune modulation.

Area of Science:

  • Immunology
  • Neuroscience
  • Pharmacology

Background:

  • Multiple Sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
  • MS relapses are often treated with corticosteroids like methylprednisolone.
  • Investigating the immune mechanisms and comparative efficacy of different administration routes is crucial.

Purpose of the Study:

  • To compare the immune mechanisms of multiple sclerosis (MS) relapse following high-dose oral methylprednisolone (oMP) versus intravenous methylprednisolone (ivMP).
  • To assess the non-inferiority of oMP compared to ivMP in managing MS relapses.
  • To evaluate the impact of both treatments on serum cytokine profiles.

Main Methods:

  • A placebo-controlled, non-inferiority clinical trial (NCT00753792) involving 49 MS patients with moderate-to-severe relapse.
  • Serum cytokines (IL-2, IL-4, IL-6, IL-10, IL-17, TNF-α, IFN-γ) were measured at baseline, 1 week, and 4 weeks post-treatment.
  • Comparison of cytokine levels between patients receiving oMP and ivMP.

Main Results:

  • Serum cytokine levels were similar between the oMP and ivMP groups at all measured time points.
  • Both oMP and ivMP significantly decreased proinflammatory cytokines, specifically IL-6 and IFN-γ, at 1 and 4 weeks post-treatment.
  • No significant differences in immune marker changes were observed between the two administration routes.

Conclusions:

  • Oral methylprednisolone (oMP) is therapeutically equivalent to intravenous methylprednisolone (ivMP) for treating MS relapses.
  • The study confirms the non-inferiority of oMP, suggesting it as a viable alternative to ivMP.
  • Both treatment forms effectively modulate key inflammatory cytokines involved in MS pathogenesis.
Keywords:
Clinical trialcytokinesdosage formsmethylprednisolonemultiple sclerosisrelapses

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