Application of Glucocorticoids in Therapy of Multiple Sclerosis

Abstract

Multiple sclerosis is an autoimmune disease affecting the central nervous system that causes significant disability and healthcare burden. Pulse-dosaged glucocorticoids therapy remains the mainstay of treatment of exacerbations of multiple sclerosis. A total of 98 patients were examined, including 28 patients with relapsing-remitting multiple sclerosis (24 women and 4 men) and 70 patients with secondary progressive multiple sclerosis (57 women and 13 men). The number of glucocorticoids therapy courses in 98 patients at all disease stages totalled 536: 98 in relapsing-remitting multiple sclerosis (9 at debuts and 89 at relapsing-remitting stage) and 438 in secondary progredient multiple sclerosis (11 at debuts, 178 at relapsing-remitting stage, and 249 at secondary progression stage). The efficacy of repeated courses of glucocorticoids therapy in patients with RR and secondary progredient multiple sclerosis was evaluated at different stages of the disease progression: debut in relapsing-remitting and secondary progredient multiple sclerosis, relapsing-remitting stage in relapsing-remitting and secondary progredient multiple sclerosis, and secondary progression stage in secondary progredient multiple sclerosis, including retrospective analysis. Important conclusions have been made about complex systemic reorganisation at different stages of relapsing-remitting and secondary-progredient types of multiple sclerosis, efficiency of glucocorticoids therapy in different types of multiple sclerosis and stages of pathological process and about influence of glucocorticoids therapy on the prognosis of the disease.