E-ISSN 1309-4866
Research Article
Monthly Pulse Methylprednisolone Therapy Is Effective in Preventing Permanent Disease Progression in Secondary Progressive Multiple Sclerosis
1 Department of Neurology, Dokuz Eylül University School of Medicine, İzmir, Turkey  
2 Clinic of Neurology, Samsun Training and Research Hospital, Samsun, Turkey  
3 Clinic of Neurology, Uşak State Hospital, Uşak, Turkey  
4 Dokuz Eylül University School of Physical Therapy and Rehabilitation, İzmir, Turkey  
Arch Neuropsychiatry ; : -
DOI: 10.5152/npa.2017.19339
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Abstract

Introduction: Secondary progressive multiple sclerosis (SPMS) is the phase in which disability continues to worsen with or without accompanying attacks. Monthly methylprednisolone pulse therapy can be used in the secondary progressive phase. The purpose of the present study was to evaluate the effects of methylprednisolone pulse therapy on the basis of clinical and MRI parameters in patients with SPMS.

 

Methods: This was a multi-center, examiner-blinded, prospective study. Patients with SPMS with EDSS scores of 3 or more, using one or none of azathioprine, interferon or glatiramer acetate, were evaluated. Patients were given IVMP (1 dose of 1 g IV) once a month for 24 months. EDSS scores, MRI findings, quality of life and adverse events were evaluated.

 

Results: Ninety-seven SPMS patients were included in the study. Significant decreases in new/enlarging, Gd-enhanced and spinal lesions were observed from baseline to year 2. EDSS scores remained stable at the end of the second year. Monthly high-dose IVMP resulted in a significant decrease in attacks.

 

 

Conclusion: This study is important in terms of emphasizing that this therapeutic option should not be overlooked, since monthly pulse therapy can halt or even reverse progression, regarded as a natural course in SPMS, albeit to a small extent.

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