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Methylprednisolone in multiple sclerosis: a comparison of oral with intravenous therapy at equivalent high dose
S M Alam1, T Kyriakides, M Lawden
1Department of Neurology, Middlesbrough General Hospital, Cleveland, UK.
Abstract:
A randomised double-blind placebo-controlled trial of intravenous methylprednisolone versus oral methylprednisolone at equivalent high dose was carried out on 35 patients with an acute relapse of multiple sclerosis (MS). After baseline evaluation each was randomly allocated to oral treatment and intravenous placebo or intravenous treatment and oral placebo, receiving 500 mg of methylprednisolone for five consecutive days and with reassessment at days five and twenty-eight. There was no significant difference in response when disability or functional scores were compared in the two groups. Adverse effects were minor and equally distributed. In this study oral treatment with methylprednisolone was as effective as intravenous treatment in acute relapse of MS.
Insights
High-dose oral methylprednisolone is as effective as intravenous methylprednisolone for treating acute relapses of multiple sclerosis (MS). This study found no significant differences in patient outcomes or adverse effects between the two administration routes.
Area of Science:
- Neurology
- Clinical Pharmacology
- Immunology
Background:
- Multiple Sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
- Acute relapses of MS significantly impact patient disability and quality of life.
- High-dose corticosteroids, particularly methylprednisolone, are a standard treatment for MS relapses.
Purpose of the Study:
- To compare the efficacy and safety of oral versus intravenous methylprednisolone in patients experiencing an acute MS relapse.
- To determine if oral administration offers equivalent therapeutic benefits to intravenous administration at high doses.
Main Methods:
- A randomized, double-blind, placebo-controlled trial was conducted.
- 35 patients with acute MS relapses received either oral or intravenous methylprednisolone (500 mg daily for five days).
- Patients were assessed at baseline, day five, and day twenty-eight using disability and functional scores.
Main Results:
- No statistically significant differences were observed in disability or functional scores between the oral and intravenous methylprednisolone groups.
- Adverse effects were minor and similarly distributed across both treatment arms.
- Oral methylprednisolone demonstrated comparable efficacy to intravenous administration in this patient cohort.
Conclusions:
- High-dose oral methylprednisolone is a viable and effective alternative to intravenous administration for managing acute multiple sclerosis relapses.
- This finding suggests a potential for increased patient convenience and reduced healthcare costs associated with oral treatment.
- Further research may explore long-term outcomes and patient-reported benefits of oral methylprednisolone in MS management.