[Prospective assessment of the treatment of multiple sclerosis relapses with oral high-dose methylprednisolone: response and tolerability data].
OBJECTIVE
This study aims to assess the response and safety of the treatment of multiple sclerosis (MS) episodes with high oral doses of methylprednisolone (MP) and to investigate the correlation between expanded disability status scale (EDSS) and MS functional composite (MSFC) during recovery from relapses.


METHODS
Patients consecutively diagnosed of clinically defined MS with an episode of less than three weeks course were included. They were evaluated and treated with a single dose of 1,000 mg of MP for three days without oral tapering. Baseline EDSS and at least three MSFC scale measurements were available. Patients were scored with EDSS and MSFC before the treatment and after 1, 4 and 12 weeks. Adverse events were also recorded. Response to treatment was defined as the recovery of at least 1 point in the EDSS or the return to baseline EDSS.


RESULTS
Twenty one episodes in 20 patients were treated. Mean baseline EDSS was, 2.5; mean baseline z-score was, 0.15, and mean relapse duration was, 6.8 days. During relapse, mean EDSS worsened to 3.8 and mean z-score to -0.57. At week 1, 33.4% of relapses had responded to treatment, and at weeks 4 and 12, 85.7% had responded. Although mean EDSS and mean z-score had already improved at week 1, mean EDSS did not reach baseline value until week 4 and mean z-score until week 12. EDSS correlated significantly to MSFC in each evaluation as well as to scale changes related to relapse (p;0.05). No serious adverse events were seen.


CONCLUSIONS
Oral high-dose of MP is a safe and effective therapy for MS relapses. Both EDSS and MSFC were sensitive to changes related to relapses although the dynamics of recovery was different, providing complementary information.
Pascual
A M
AM
Servicios de Neurología, Hospital Universitario La Fe, Valencia. med004201@saludalia.com
Boscá
I
I
Escutia
M
M
Bernat
A
A
Coret
F
F
Casanova
B
B
D000328:Adult; D004185:Disability Evaluation; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000188:drug therapy / Q000503:physiopathology* / Q000517:prevention & control*; D011446:Prospective Studies; D012008:Recurrence; D012720:Severity of Illness Index; D016896:Treatment Outcome
D005938:Glucocorticoids; D008775:Methylprednisolone