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Updated: Feb 25, 2026
A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data
Published on: December 9, 2015
Outcome of MS relapses in the era of disease-modifying therapy
Muriel Stoppe1,2, Maria Busch1, Luise Krizek1
1Department of Neurology, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany.
Background:
In multiple sclerosis (MS), neurological disability results from incomplete remission of relapses and from relapse-independent progression. Intravenous high dose methylprednisolone (IVMP) is the established standard treatment to accelerate clinical relapse remission, although some patients do not respond. Most studies of relapse treatment have been performed when few patients received disease-modifying treatment and may no longer apply today.
Methods:
We prospectively assessed, over one year, the course of patients who presented with a clinically isolated syndrome (CIS) or MS relapse, documenting demographic, clinical, treatment and outcome data. A standardized follow-up examination was performed 10-14 days after end of relapse treatment.
Results:
We documented 119 relapses in 108 patients (31 CIS, 77 MS). 114 relapses were treated with IVMP resulting in full remission (29.2%), partial remission (38.7%), no change (18.2%) or worsening (4.4%). In 27 relapses (22.7%), escalating relapse treatment was indicated, and performed in 24, using double-dose IVMP (n = 18), plasmapheresis (n = 2) or immunoadsorption (n = 4).
Conclusions:
Standardised follow-up visits and outcome documentation in treated relapses led to escalating relapse treatment in every fifth relapse. We recommend incorporating scheduled follow-up visits into routine relapse management. Our data facilitate the design of prospective trials addressing methods and timelines of relapse treatment.
Insights
Standard follow-up after multiple sclerosis (MS) relapse treatment identified the need for escalated therapy in 22.7% of cases. Scheduled follow-ups improve relapse management and inform future clinical trials.
Area of Science:
- Neurology
- Clinical Medicine
Background:
- Neurological disability in multiple sclerosis (MS) stems from incomplete relapse remission and progression.
- Intravenous high-dose methylprednisolone (IVMP) is standard for accelerating relapse remission, but response varies.
- Current relapse treatment studies may not reflect modern disease-modifying treatment use.
Purpose of the Study:
- To prospectively assess patient outcomes after relapse treatment over one year.
- To evaluate the effectiveness of standard and escalated relapse treatments in MS and clinically isolated syndrome (CIS).
Main Methods:
- Prospective assessment of 108 patients (119 relapses) with CIS or MS over one year.
- Standardized follow-up examinations 10-14 days post-treatment.
- Documentation of demographic, clinical, treatment, and outcome data.
Main Results:
- IVMP treated 114 relapses, achieving full remission in 29.2%, partial in 38.7%, no change in 18.2%, and worsening in 4.4%.
- Escalated relapse treatment was indicated in 22.7% of relapses and performed in 24 patients.
- Escalation methods included double-dose IVMP, plasmapheresis, and immunoadsorption.
Conclusions:
- Scheduled follow-up visits and outcome documentation identified the need for escalated relapse treatment in approximately one in five cases.
- Routine incorporation of scheduled follow-up visits into relapse management is recommended.
- Study data can inform the design of future trials on relapse treatment strategies and timing.
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