Analyzing the impact of pulse steroid therapy on relapse rates and disease progression in relapsing-remitting multiple sclerosis: a comprehensive retrospective study

Abstract

Background and Objective: Relapsing remitting MS (RRMS) is characterized by recurrent relapses with remissions. Over an extended time-frame, high-dose steroid administration has primarily centered on the treatment of acute relapses, rather than relapse prevention. The objective of this retrospective study is to assess the long-term impact of administering three monthly pulse steroid therapy for three days on relapse rates and the Expanded Disability Status Scale (EDSS) scores in patients with RRMS. Methods: This study was conducted at Neurology ward of Chandka Medical College Hospital in Larkana from January 2021 to January 2023. A retrospective analysis of historical patient data, focusing on individuals with RRMS who received three monthly pulse steroid therapy over a specified period. Data was collected through patient records, including details of treatment, relapse history, and EDSS scores. Results: Thirty MS patients including 25 females and five males received one gram methylprednisolone intravenously every three months for three days. The mean age range was 18-50 years. Among them, three experienced no relapses, 11 had one relapse, 13 encountered two relapses, and three had three relapses over next consecutive two years. The severity of relapses varied, with 20 classified as moderate and seven as severe. A reduction in relapse rates and notable improvements in EDSS scores were observed. Conclusion: The initial findings from this retrospective analysis suggest that three monthly pulse steroid therapy is associated with positive outcomes in RRMS patients. These results support the need for further investigation into the potential benefits of continuous steroid therapy in managing RRMS.