Pilot-study on large-dose alternate-day steroid therapy in multiple sclerosis.
Twenty-one patients with multiple sclerosis (MS) were given on alternate day larger doses of dexamethasone (4-8 mg) for 1 to 4 cycles and were followed up for an average of 5 months. In the group of 11 patients with relapsing course slightly better improvement was found immediately after first 5 weeks course of alternate-day intensive steroid therapy (ADST) (mean score -1.6 in numerical rating) than in 11 patients taking azathioprine (-0.9). The difference between these two relapsing groups tended to reach the level of statistical significance (p less than 0.10). Long-term effects of ADST or azathioprine treatment in patients with acute relapses were completely negative. The rate of relapse per patient-year was 0.45 in the ADST group and 0.80 in the azathioprine group. This difference was also not significant. Mild side-effects of ADST were found only in 4 patients (19%). Although the number of patients is small and the period of follow-up is limited, it can be assumed that immediate clinical effects of intensive ADST in acute relapses of MS are slightly superior to that of azathioprine. However, ADST did not affect the overall rate of clinical deterioration.
D000293:Adolescent; D000328:Adult; D001379:Azathioprine / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy*; D012008:Recurrence
D003907:Dexamethasone; D001379:Azathioprine