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Evaluation of liver injury in multiple sclerosis patients receiving pulsed steroid therapy

Pooria Namaei1, Fereshteh Ghadiri1, Raika Jamali2

  • 1Multiple Sclerosis Research Center, Neuroscience institute, Tehran University of Medical Sciences, Tehran, Iran.

Multiple Sclerosis and Related Disorders
|July 2, 2022
PubMed
Abstract

Insights

Pulsed methylprednisolone therapy for multiple sclerosis (MS) can cause liver injury in 2.86% of patients. Risk factors include hyperlipidemia and alcohol abuse, necessitating liver function monitoring.

Area of Science:

  • Neurology
  • Hepatology
  • Pharmacology

Background:

  • Multiple sclerosis (MS) is a chronic neurological disease.
  • Pulsed methylprednisolone therapy is a common treatment for MS relapses.
  • Data on methylprednisolone-induced liver injury in MS patients is limited.

Purpose of the Study:

  • To determine the incidence and severity of liver injury in MS patients treated with pulsed methylprednisolone.
  • To identify risk factors associated with methylprednisolone-induced liver injury in MS patients.

Main Methods:

  • Prospective observational study of 314 MS patients receiving methylprednisolone pulses.
  • Evaluation of demographic, clinical characteristics, and liver function tests.
  • Liver injury defined by elevated serum aminotransferase levels (>45 IU/L).

Main Results:

  • Prevalence of liver injury was 2.86%; no cases were severe.
  • Patients with liver injury had higher rates of hyperlipidemia, alcohol abuse, and non-alcoholic fatty liver disease (NAFLD).
  • Hyperlipidemia (OR: 6.31) and alcohol abuse (OR: 36.71) were significant risk factors for liver injury.

Conclusions:

  • Close monitoring of liver function tests is crucial for MS patients undergoing pulsed methylprednisolone therapy.
  • Particular attention should be paid to patients with pre-existing NAFLD, hyperlipidemia, or a history of alcohol abuse.
  • This study underscores the need for proactive management to mitigate potential hepatotoxicity from methylprednisolone treatment in MS.
Keywords:
AlcoholHyperlipidemiaLiver injuryMethylprednisoloneMultiple sclerosis

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