Steroid therapy in multiple sclerosis. Point of view.
A number of studies have demonstrated that high-dose corticosteroid treatment improves the rate of recovery from acute exacerbations of multiple sclerosis. The beneficial effect is more rapidly and consistently produced by high-dose corticosteroid administration than with adrenocorticotropic hormone. The most rapid improvement in clinical condition and cerebrospinal fluid parameters of patients has been observed with short courses of very high-dose intravenous therapy. This form of treatment would be most advantageous for patients with severe and rapidly progressive exacerbations. Ultimately, the duration of treatment will depend on the patient's response to treatment, tolerance of corticosteroid withdrawal, and the occurrence of significant complications of therapy. However, in our experience, a three- to four-month slowly tapered course of oral therapy is often needed, and is usually well tolerated, with few serious side effects when given once daily in the morning.
Troiano
R
R
Cook
S D
SD
Dowling
P C
PC
D000208:Acute Disease; D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000324:Adrenocorticotropic Hormone / Q000627:therapeutic use; D001921:Brain / Q000000981:diagnostic imaging; D002986:Clinical Trials as Topic; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging / Q000188:drug therapy*; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D000305:Adrenal Cortex Hormones; D007074:Immunoglobulin G; D000324:Adrenocorticotropic Hormone