title: Efficacy of intravenous methylprednisolone pulse therapy in patients with multiple sclerosis and neuromyelitis optica.
abstract: No large-scale studies have compared the efficacy of intravenous methylprednisolone pulse therapy (IVMP) for multiple sclerosis (MS) and neuromyelitis optica (NMO).
  
  
  
  To explain differences in treatment responses of MS and NMO patients to IVMP.
  
  
  
  Changes in neurological symptoms/signs and Expanded Disability Status Scale (EDSS) scores before and within 1 week of IVMP completion were obtained in 2010 at 28 institutions, and retrospectively collated from 271 MS (478 courses) and 73 NMO (118 courses) cases.
  
  
  
  In MS patients, decreased EDSS score was significant after the first (-0.8 ± 0.9), second (-0.7 ± 0.9), and third (-0.7 ± 0.8) courses (p < 0.05), but not after the fourth (-0.3 ± 0.7) and fifth (-0.5 ± 0.6). However, decreased EDSS score was only significant after the first course (-0.5 ± 1.5, p < 0.05) in NMO patients. EDSS score was significantly decreased in MS compared with NMO patients at the first course (p < 0.05), but not thereafter. Model analysis for EDSS score improvement at the first course, adjusting for covariates, showed significantly greater decreases in MS compared with NMO patients (p < 0.05).
  
  
  
  IVMP is effective in MS from the first to third courses, and in NMO at the first course. Additionally, IVMP is more efficacious in MS than NMO patients, even at the first course.
authors.affiliation: Department of Neurological Therapeutics, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Yamasaki
authors.affiliation: Department of Neurological Therapeutics, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Matsushita
authors.affiliation: Sapporo Neurology Clinic, Sapporo, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Fukazawa
authors.affiliation: Department of Neurology, Graduate School of Medicine, Juntendo University, Tokyo, Japan.
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Yokoyama
authors.affiliation: Department of Multiple Sclerosis Therapeutics, Graduate School of Medicine, Tohoku University, Sendai, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Fujihara
authors.affiliation: Department of Neurology, Kitasato University School of Medicine, Sagamihara, Japan.
authors.forename: Mieko
authors.initials: M
authors.lastname: Ogino
authors.affiliation: Department of Neurology and Neurological Science, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Yokota
authors.affiliation: Department of Neurology, Kinki University School of Medicine, Osaka, Japan.
authors.forename: Katsuichi
authors.initials: K
authors.lastname: Miyamoto
authors.affiliation: Department of Clinical Research, NHO Hokkaido Medical Center, Sapporo, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Niino
authors.affiliation: Department of Neurology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Nomura
authors.affiliation: Department of Neurology, Saitama Medical University, Saitama, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Tomioka
authors.affiliation: Multiple Sclerosis Center, NHO Utano National Hospital, Kyoto, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Department of Neurology, Brain Research Institute, Niigata University, Niigata, Japan.
authors.forename: Izumi
authors.initials: I
authors.lastname: Kawachi
authors.affiliation: Department of Neurology, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohashi
authors.affiliation: Department of Neurology, National Defense Medical College, Tokorozawa, Japan.
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Kaida
authors.affiliation: Department of Neurology, Kanazawa Medical University, Kanazawa, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Matsui
authors.affiliation: Department of Neurology, Osaka University, Osaka, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nakatsuji
authors.affiliation: Department of Neurology, Graduate School of Medicine, Ehime University, Matsuyama, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Ochi
authors.affiliation: Department of Neurology, Iwate Medical University, Morioka, Japan.
authors.forename: Hikoaki
authors.initials: H
authors.lastname: Fukaura
authors.affiliation: Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanda
authors.affiliation: Department of Neurology, NHO Nagasaki Kawatana Medical Center, Kawatana, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Nagaishi
authors.affiliation: Clinical Statistics, Pfizer Japan Inc., Tokyo, Japan.
authors.forename: Kanae
authors.initials: K
authors.lastname: Togo
authors.affiliation: Department of Neurology and Neurological Science, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Mizusawa
authors.affiliation: Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Murai
authors.affiliation: Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan kira@neuro.med.kyushu-u.ac.jp.
authors.forename: Jun-Ichi
authors.initials: J
authors.lastname: Kira
mesh_terms: D061605:Administration, Intravenous; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy*; D009471:Neuromyelitis Optica / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone
keywords: Multiple sclerosis; corticosteroids; methylprednisolone; neuromyelitis optica; pulse therapy