A randomized pilot trial of oral prednisone taper vs placebo following iv methylprednisolone for multiple sclerosis relapses: Effects on adrenal function and clinical efficacy.


Journal

Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247

Informations de publication

Date de publication:
May 2021
Historique:
received: 11 11 2020
revised: 26 01 2021
accepted: 22 02 2021
pubmed: 8 3 2021
medline: 15 5 2021
entrez: 7 3 2021
Statut: ppublish

Résumé

We performed a pilot trial investigating the effect of a steroid taper on adrenal function and safety measures after acute MS relapses. Twenty-five patients were randomized to either prednisone taper (n=12) or placebo (n=13) after 3 days of intravenous methylprednisolone. No patient showed signs of adrenal insufficiency at any time by cortisol response to ACTH. This significantly increased between baseline and 6 months in both groups. Patients remained clinically and radiologically stable, but those under prednisone taper experienced more frequently mood disorders, hyperglycaemia and weight increase. If confirmed by sufficiently powered studies, these results would question the need of a steroid taper following short-term intravenous methylprednisolone.

Identifiants

pubmed: 33677411
pii: S2211-0348(21)00133-4
doi: 10.1016/j.msard.2021.102867
pii:
doi:

Substances chimiques

Prednisone VB0R961HZT
Methylprednisolone X4W7ZR7023

Types de publication

Letter Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

102867

Informations de copyright

Copyright © 2021. Published by Elsevier B.V.

Auteurs

Chiara Zecca (C)

Multiple sclerosis Center, Department of Neurology, Neurocenter of Southern Switzerland, Ospedale regionale di Lugano, Lugano, Switzerland; Faculty of biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.

Giulio Disanto (G)

Multiple sclerosis Center, Department of Neurology, Neurocenter of Southern Switzerland, Ospedale regionale di Lugano, Lugano, Switzerland.

Gianna C Riccitelli (GC)

Multiple sclerosis Center, Department of Neurology, Neurocenter of Southern Switzerland, Ospedale regionale di Lugano, Lugano, Switzerland.

Ursula Candrian (U)

Multiple sclerosis Center, Department of Neurology, Neurocenter of Southern Switzerland, Ospedale regionale di Lugano, Lugano, Switzerland.

Maurilio Deandrea (M)

Endocrinology, Diabetes and Metabolism Unit, A.O. Ordine Mauriziano, Torino, Italy.

Paolo Piero Limone (PP)

Endocrinology, Diabetes and Metabolism Unit, A.O. Ordine Mauriziano, Torino, Italy.

Rosaria Sacco (R)

Multiple sclerosis Center, Department of Neurology, Neurocenter of Southern Switzerland, Ospedale regionale di Lugano, Lugano, Switzerland.

Claudio Gobbi (C)

Multiple sclerosis Center, Department of Neurology, Neurocenter of Southern Switzerland, Ospedale regionale di Lugano, Lugano, Switzerland; Faculty of biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland. Electronic address: claudio.gobbi@eoc.ch.

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Classifications MeSH