title: High dose oral steroids commonly used to treat relapses in Canadian MS clinics.
abstract: BACKGROUND
  Glucocorticoid treatment improves the speed of functional recovery of acute multiple sclerosis (MS) relapses but has not been shown to provide any long-term functional benefit. There is currently no convincing evidence that the clinical benefit is influenced by the route of administration or the dosage of glucocorticoid, or the particular glucocorticoid prescribed. Recent studies support similarities in the bioequivalence and in the clinical effect of high dose oral corticosteroids for MS relapses.
  
  
  OBJECTIVE
  This survey aimed to determine the relapse treatment preferences of clinicians in Canadian MS clinics.
  
  
  METHODS
  Members of the Canadian Network of MS Clinics are linked by an email server. A one page survey was distributed to the group to determine and report use of corticosteroids to manage MS relapses amongst Canadian MS specialists.
  
  
  RESULTS
  Fifty-one clinicians from 17 MS clinics were surveyed. 32 (63%) surveys were returned representing 16 clinics. Five doses are most commonly prescribed, usually without a taper. Three or four doses and the use of a corticosteroid taper, however, are not uncommon. Gastric cytoprotection and sedatives are often prescribed for use as needed.
  
  
  CONCLUSIONS
  This survey illustrates that when Canadian clinicians with expertise in managing MS treat MS relapses they choose high dose corticosteroids, either oral or i.v. The results therefore represent Canadian practice as these clinicians provide direct patient care and influence care by community neurologists. Until evidence clearly identifies a superior practice all options should be available to clinicians and their patients.
authors.affiliation: Department of Clinical Neurosciences, University of Western Ontario, London, Ontario, Canada.
authors.forename: S A
authors.initials: SA
authors.lastname: Morrow
authors.forename: L M
authors.initials: LM
authors.lastname: Metz
authors.forename: M
authors.initials: M
authors.lastname: Kremenchutzky
mesh_terms: D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D002170:Canada; D006801:Humans; D007275:Injections, Intravenous; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*
chemical_list: D000305:Adrenal Cortex Hormones