Corticosteroids in the treatment of multiple sclerosis

Acta Neurol Scand Suppl. 2009:(189):73-80. doi: 10.1111/j.1600-0404.2009.01213.x.

Abstract

Background: Multiple sclerosis (MS) is an immune-mediated inflammatory disease of the central nervous system (CNS) that usually is clinically characterized by repeated subacute relapses followed by remissions. Therapeutic strategies include corticosteroid treatment of relapses and immunomodulatory- or immunosuppressive treatment to prevent new relapses and progression of disability.

Objectives: To review the evidences for the use of corticosteroids in the treatment of relapses in MS as well as its possible disease modifying potential.

Materials & methods: Available literature from PubMed search and personal experiences on corticosteroid treatment in multiple sclerosis were reviewed.

Results: High dose short-term oral or intravenous methylprednisolone for 3-5 days speed up recovery from relapses, but the treatment has no influence on the occurrence of new relapses or long-term disability. There is also some evidence that pulsed treatment with methylprednisolone have beneficial long-term effects in multiple sclerosis.

Conclusion: Relapses with moderate to serious disability should be treated with high dose intravenous or oral methylprednisolone. More data is needed to determine long-term disease modifying effects of corticosteroids.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / therapeutic use*
  • Adrenocorticotropic Hormone / administration & dosage
  • Adrenocorticotropic Hormone / therapeutic use*
  • Humans
  • Interferon-beta / therapeutic use
  • Multiple Sclerosis / drug therapy*
  • Multiple Sclerosis / prevention & control
  • Recovery of Function
  • Recurrence

Substances

  • Adrenal Cortex Hormones
  • Interferon-beta
  • Adrenocorticotropic Hormone