Treatment Of Acute Relapses Research Articles

Oral and intravenous methylprednisolone were equally efficacious for relapses in multiple sclerosis

TherapeuticsSeptember 1, 1997Oral and intravenous methylprednisolone were equally efficacious for relapses in multiple sclerosisT. Jock Murray, OC, MDT. Jock Murray, OC, MDDalhousie University, Halifax, Nova Scotia, Canada (T.J.M.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/ACPJC-1997-127-2-038 SectionsAboutFull Text ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookTwitterLinkedInRedditEmail Source CitationBarnes D, Hughes RA, Morris RW, et al. Randomised trial of oral and intravenous methylprednisolone in acute relapses of multiple sclerosis. Lancet. 1997 Mar 29;349:902-6.References1 Thompson AJ, Kennard C, Swash M, et al. Relative efficacy of intravenous methylprednisolone and ACTH in the treatment of acute relapse in MS. Neurology. 1989;39:969-71. Google Scholar2 Milligan NM, Newcombe R, Compston DA. A double-blind controlled trial of high dose methylprednisolone in patients with multiple sclerosis: 1. Clinical effects. J Neurol Neurosurg Psychiatry. 1987;50:511-6. Google Scholar Author, Article, and Disclosure InformationAffiliations: Dalhousie University, Halifax, Nova Scotia, Canada (T.J.M.) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails September 1, 1997Volume 127, Issue 2Page: 38KeywordsClinical trialsDrugsEvoked potentialsGlucoseImmunosuppressivesMagnetic resonance imagingMultiple sclerosisSteroid therapySteroidsWalking ePublished: 9 March 2020 Issue Published: September 1, 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.Loading ...

Emerging treatments in multiple sclerosis.

Currently used and developing therapies for multiple sclerosis (MS) are dealing with the treatment of acute exacerbations, the prevention of relapses and of the progression of neurological handicap, the treatment of symptoms, and the repair of demyelinated lesions. New insights into the treatment of acute relapses as well as recent immunomodulatory and immunosuppressive agents tested in MS are exposed in this brief review. Interferon-beta (1a and 1b), copolymer 1 and new immunosuppressive therapies are particularly discussed with emphasis on their potential to alter the course of MS.

The Use of Placebos in Clinical Trials for Acute Schizophrenia

This review examines the scientific and ethical justification for the use of randomized concurrent placebo-controlled trials in the treatment of acute relapse in chronic schizophrenia. A literature search was conducted, and the national regulatory authority was consulted. Many placebo-controlled studies of acute or chronic schizophrenia are being published and it is the official position of both the Canadian and US regulatory authorities that such studies are required for both scientific and ethical reasons. The specific strengths and limitations of placebo-controlled studies are reviewed. Examples, drawn from Canadian studies, are presented to illustrate their benefits. It is concluded that the use of placebos in the particular situation of acute or chronic schizophrenia is ethically and scientifically justified. It forms an essential component of a comprehensive drug evaluation for new antipsychotic medications.

High dose steroids in acute relapses of multiple sclerosis: MRI evidence for a possible mechanism of therapeutic effect.

The integrity of the blood-brain barrier (BBB) in multiple sclerosis (MS) was monitored by serial gadolinium-(Gd)-DTPA enhanced MRI during and after the treatment of acute relapses with a three day course of high dose intravenous methylprednisolone (IVMP). During treatment there was a rapid reduction of BBB abnormalities in 96% of enhancing lesions. In spite of sustained clinical improvement, many lesions re-enhanced within a few days of stopping IVMP, and new lesions frequently appeared within one month. It is possible that the rapid, albeit transient, reversal of BBB abnormalities contributes to the accelerated recovery from relapses associated with IVMP treatment.

Relative efficacy of intravenous methylprednisolone and ACTH in the treatment of acute relapse in MS

To compare the efficacy of high-dose intravenous methylprednisolone with intramuscular ACTH in the treatment of acute relapse in multiple sclerosis, we undertook a double-blind, randomized, controlled study involving 61 patients. There was a marked improvement in both groups in the course of the study, but no difference between them in either the rate of recovery or the final outcome. High-dose IV methylprednisolone is a safe alternative to ACTH in the management of acute relapse in MS.