Corticosteroids in the treatment of multiple sclerosis
Myhr, K.M.; Mellgren, S.I.
Acta Neurologica Scandinavica. Supplementum 189: 73-80
ISSN/ISBN: 1600-5449 PMID: 19566504 DOI: 10.1111/j.1600-0404.2009.01213.x
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. To review the evidences for the use of corticosteroids in the treatment of relapses in MS as well as its possible disease modifying potential. Available literature from PubMed search and personal experiences on corticosteroid treatment in multiple sclerosis were reviewed. 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. 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.