title: A cross-sectional, multicentre study of the therapeutic management of multiple sclerosis relapses in Italy.
abstract: Despite the existence of therapeutic guidelines, management of multiple sclerosis relapse remains heterogeneous. Optimisation of relapse outcome demands an improved understanding of the neurologist's therapeutic attitude towards relapse management, which is the aim of this study. Neurologists from 13 multiple sclerosis centres completed a questionnaire every time they assessed multiple sclerosis relapses. The questionnaire requested a guided description of the relapse's clinical characteristics and an indication of the prescribed therapy, supported with up to 3 out of 20 suggested reasons. Over 3 months, 368 questionnaires were collected. Median percentage (%) of 21 relapses resulting in a prescription was 88.9%. Corticosteroids represented the most frequent prescription. A short-course of high-dose intravenous methylprednisolone was the most used corticosteroid (73.7%). Treatment was administrated mainly in day case unit (80.0%) and at home (13.6%). A tapered therapy was prescribed to 28.8% of patients. Neurologists' therapeutic decisions were driven mainly by relapse severity (45.3%) and symptom evolution (24.2%). Our study confirms the therapeutic attitude of multiple sclerosis specialists in treating relapses with high-dose intravenous corticosteroids in a day hospital setting, with a tapering in a proportion of cases. The main reasons for prescription are relapse severity and symptom evolution.
authors.affiliation: S. Antonio Abate Hospital, Gallarate, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Annovazzi
authors.forename: Valentina
authors.initials: V
authors.lastname: Tomassini
authors.forename: Benedetta
authors.initials: B
authors.lastname: Bodini
authors.forename: Laura
authors.initials: L
authors.lastname: Boffa
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Calabrese
authors.forename: Eleonora
authors.initials: E
authors.lastname: Cocco
authors.forename: Cinzia
authors.initials: C
authors.lastname: Cordioli
authors.forename: Giovanna
authors.initials: G
authors.lastname: De Luca
authors.forename: Giovanni
authors.initials: G
authors.lastname: Frisullo
authors.forename: Antonio
authors.initials: A
authors.lastname: Gallo
authors.forename: Simona
authors.initials: S
authors.lastname: Malucchi
authors.forename: Damiano
authors.initials: D
authors.lastname: Paolicelli
authors.forename: Ilaria
authors.initials: I
authors.lastname: Pesci
authors.forename: Marta
authors.initials: M
authors.lastname: Radaelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Ragonese
authors.forename: Luca
authors.initials: L
authors.lastname: Roccatagliata
authors.forename: Carla
authors.initials: C
authors.lastname: Tortorella
authors.forename: Marco
authors.initials: M
authors.lastname: Vercellino
authors.forename: Valentina
authors.initials: V
authors.lastname: Zipoli
authors.forename: Claudio
authors.initials: C
authors.lastname: Gasperini
authors.forename: Mariaemma
authors.initials: M
authors.lastname: Rodegher
authors.forename: Claudio
authors.initials: C
authors.lastname: Solaro
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007558:Italy; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy*; D009462:Neurology; D012008:Recurrence; D011795:Surveys and Questionnaires
chemical_list: D000305:Adrenal Cortex Hormones; D008775:Methylprednisolone