title: MS patients report excellent compliance with oral prednisone for acute relapses.
abstract: BACKGROUND
  Multiple Sclerosis is characterized by relapses separated by periods of relative quiescence. High dose intravenous corticosteroid pulses for three to five days is the current standard for the treatment of acute relapses, but recent evidence supports the use of equivalent doses of oral therapy as an alternative. The highest single dose preparation of oral prednisone is a 50mg tablet, requiring patients to take 25 tablets a day. Questions regarding compliance with this oral regimen have been raised.
  
  
  OBJECTIVE
  To determine whether MS patients are complaint with 1,250 mg of oral prednisone daily for acute relapses.
  
  
  METHODS
  Between November 2008 and December 2009, all patients diagnosed with an acute relapse in the London (Ontario) MS clinic were prospectively identified. If treatment with oral prednisone was initiated, subjects were given a survey to be mailed anonymously to the clinic.
  
  
  RESULTS
  Sixty eight MS relapses were diagnosed and treated with corticosteroids in 66 patients of which 60 (58 subjects) were treated with 1,250 mg prednisone. Fifty-three (91.4%) surveys were returned. The reported compliance rate was high at 94.3% (50/53) with only one patient reporting being unable to take all the required pills due to intolerance. Most subjects (43, 86.0%) encountered at least one side effect, most commonly insomnia, mood changes and increased appetite. Two thirds of subjects (69.8%) indicated a preference for oral medication for future relapses.
  
  
  CONCLUSIONS
  High dose (1,250 mg) oral prednisone is an acceptable therapy to MS patients for the treatment of acute relapses with a high rate of compliance.
authors.affiliation: University of Western Ontario, LSHC-UH B10-118, 339 Windermere Rd, London, Ontario, N6G 1W8, Canada. smorrow8@uwo.ca
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Morrow
authors.forename: Lynn
authors.initials: L
authors.lastname: McEwan
authors.forename: Katayoun
authors.initials: K
authors.lastname: Alikhani
authors.forename: Christopher
authors.initials: C
authors.lastname: Hyson
authors.forename: Marcelo
authors.initials: M
authors.lastname: Kremenchutzky
mesh_terms: D000284:Administration, Oral; D000328:Adult; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000523:psychology*; D010349:Patient Compliance; D011241:Prednisone / Q000008:administration & dosage*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D011241:Prednisone