TY - JOUR
T1 - Efficacy of intravenous methylprednisolone pulse therapy in patients with multiple sclerosis and neuromyelitis optica
AU - Yamasaki, Ryo
AU - Matsushita, Takuya
AU - Fukazawa, Toshiyuki
AU - Yokoyama, Kazumasa
AU - Fujihara, Kazuo
AU - Ogino, Mieko
AU - Yokota, Takanori
AU - Miyamoto, Katsuichi
AU - Niino, Masaaki
AU - Nomura, Kyoichi
AU - Tomioka, Ryo
AU - Tanaka, Masami
AU - Kawachi, Izumi
AU - Ohashi, Takashi
AU - Kaida, Ken Ichi
AU - Matsui, Makoto
AU - Nakatsuji, Yuji
AU - Ochi, Hirofumi
AU - Fukaura, Hikoaki
AU - Kanda, Takashi
AU - Nagaishi, Akiko
AU - Togo, Kanae
AU - Mizusawa, Hidehiro
AU - Murai, Hiroyuki
AU - Kira, Jun Ichi
PY - 2016/9/1
Y1 - 2016/9/1
N2 - Background: No large-scale studies have compared the efficacy of intravenous methylprednisolone pulse therapy (IVMP) for multiple sclerosis (MS) and neuromyelitis optica (NMO). Objective: To explain differences in treatment responses of MS and NMO patients to IVMP. Methods: Changes in neurological symptoms/signs and Expanded Disability Status Scale (EDSS) scores before and within 1 week of IVMP completion were obtained in 2010 at 28 institutions, and retrospectively collated from 271 MS (478 courses) and 73 NMO (118 courses) cases. Results: In MS patients, decreased EDSS score was significant after the first (-0.8 ± 0.9), second (-0.7 ± 0.9), and third (-0.7 ± 0.8) courses (p < 0.05), but not after the fourth (-0.3 ± 0.7) and fifth (-0.5 ± 0.6). However, decreased EDSS score was only significant after the first course (-0.5 ± 1.5, p < 0.05) in NMO patients. EDSS score was significantly decreased in MS compared with NMO patients at the first course (p < 0.05), but not thereafter. Model analysis for EDSS score improvement at the first course, adjusting for covariates, showed significantly greater decreases in MS compared with NMO patients (p < 0.05). Conclusion: IVMP is effective in MS from the first to third courses, and in NMO at the first course. Additionally, IVMP is more efficacious in MS than NMO patients, even at the first course.
AB - Background: No large-scale studies have compared the efficacy of intravenous methylprednisolone pulse therapy (IVMP) for multiple sclerosis (MS) and neuromyelitis optica (NMO). Objective: To explain differences in treatment responses of MS and NMO patients to IVMP. Methods: Changes in neurological symptoms/signs and Expanded Disability Status Scale (EDSS) scores before and within 1 week of IVMP completion were obtained in 2010 at 28 institutions, and retrospectively collated from 271 MS (478 courses) and 73 NMO (118 courses) cases. Results: In MS patients, decreased EDSS score was significant after the first (-0.8 ± 0.9), second (-0.7 ± 0.9), and third (-0.7 ± 0.8) courses (p < 0.05), but not after the fourth (-0.3 ± 0.7) and fifth (-0.5 ± 0.6). However, decreased EDSS score was only significant after the first course (-0.5 ± 1.5, p < 0.05) in NMO patients. EDSS score was significantly decreased in MS compared with NMO patients at the first course (p < 0.05), but not thereafter. Model analysis for EDSS score improvement at the first course, adjusting for covariates, showed significantly greater decreases in MS compared with NMO patients (p < 0.05). Conclusion: IVMP is effective in MS from the first to third courses, and in NMO at the first course. Additionally, IVMP is more efficacious in MS than NMO patients, even at the first course.
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U2 - 10.1177/1352458515617248
DO - 10.1177/1352458515617248
M3 - Article
C2 - 26564994
AN - SCOPUS:84986626313
VL - 22
SP - 1337
EP - 1348
JO - Multiple Sclerosis
JF - Multiple Sclerosis
SN - 1352-4585
IS - 10
ER -