Efficacy of intravenous methylprednisolone pulse therapy in patients with multiple sclerosis and neuromyelitis optica

Ryo Yamasaki; Takuya Matsushita; Toshiyuki Fukazawa; Kazumasa Yokoyama; Kazuo Fujihara; Mieko Ogino; Takanori Yokota; Katsuichi Miyamoto; Masaaki Niino; Kyoichi Nomura; Ryo Tomioka; Masami Tanaka; Izumi Kawachi; Takashi Ohashi; Ken Ichi Kaida; Makoto Matsui; Yuji Nakatsuji; Hirofumi Ochi; Hikoaki Fukaura; Takashi Kanda; Akiko Nagaishi; Kanae Togo; Hidehiro Mizusawa; Hiroyuki Murai; Jun Ichi Kira

doi:10.1177/1352458515617248

Efficacy of intravenous methylprednisolone pulse therapy in patients with multiple sclerosis and neuromyelitis optica

Ryo Yamasaki, Takuya Matsushita, Toshiyuki Fukazawa, Kazumasa Yokoyama, Kazuo Fujihara, Mieko Ogino, Takanori Yokota, Katsuichi Miyamoto, Masaaki Niino, Kyoichi Nomura, Ryo Tomioka, Masami Tanaka, Izumi Kawachi, Takashi Ohashi, Ken Ichi Kaida, Makoto Matsui, Yuji Nakatsuji, Hirofumi Ochi, Hikoaki Fukaura, Takashi KandaAkiko Nagaishi, Kanae Togo, Hidehiro Mizusawa, Hiroyuki Murai, Jun Ichi Kira

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Abstract

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.

Original language	English
Pages (from-to)	1337-1348
Number of pages	12
Journal	Multiple Sclerosis
Volume	22
Issue number	10
DOIs	https://doi.org/10.1177/1352458515617248
Publication status	Published - Sep 1 2016

All Science Journal Classification (ASJC) codes

Neurology
Clinical Neurology

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Yamasaki, R., Matsushita, T., Fukazawa, T., Yokoyama, K., Fujihara, K., Ogino, M., Yokota, T., Miyamoto, K., Niino, M., Nomura, K., Tomioka, R., Tanaka, M., Kawachi, I., Ohashi, T., Kaida, K. I., Matsui, M., Nakatsuji, Y., Ochi, H., Fukaura, H., ... Kira, J. I. (2016). Efficacy of intravenous methylprednisolone pulse therapy in patients with multiple sclerosis and neuromyelitis optica. Multiple Sclerosis, 22(10), 1337-1348. https://doi.org/10.1177/1352458515617248

Yamasaki, R, Matsushita, T, Fukazawa, T, Yokoyama, K, Fujihara, K, Ogino, M, Yokota, T, Miyamoto, K, Niino, M, Nomura, K, Tomioka, R, Tanaka, M, Kawachi, I, Ohashi, T, Kaida, KI, Matsui, M, Nakatsuji, Y, Ochi, H, Fukaura, H, Kanda, T, Nagaishi, A, Togo, K, Mizusawa, H, Murai, H & Kira, JI 2016, 'Efficacy of intravenous methylprednisolone pulse therapy in patients with multiple sclerosis and neuromyelitis optica', Multiple Sclerosis, vol. 22, no. 10, pp. 1337-1348. https://doi.org/10.1177/1352458515617248

@article{445a0132660e4f27bc2ee9e6c7ddfe9d,

title = "Efficacy of intravenous methylprednisolone pulse therapy in patients with multiple sclerosis and neuromyelitis optica",

abstract = "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.",

author = "Ryo Yamasaki and Takuya Matsushita and Toshiyuki Fukazawa and Kazumasa Yokoyama and Kazuo Fujihara and Mieko Ogino and Takanori Yokota and Katsuichi Miyamoto and Masaaki Niino and Kyoichi Nomura and Ryo Tomioka and Masami Tanaka and Izumi Kawachi and Takashi Ohashi and Kaida, {Ken Ichi} and Makoto Matsui and Yuji Nakatsuji and Hirofumi Ochi and Hikoaki Fukaura and Takashi Kanda and Akiko Nagaishi and Kanae Togo and Hidehiro Mizusawa and Hiroyuki Murai and Kira, {Jun Ichi}",

year = "2016",

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day = "1",

doi = "10.1177/1352458515617248",

language = "English",

volume = "22",

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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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Efficacy of intravenous methylprednisolone pulse therapy in patients with multiple sclerosis and neuromyelitis optica

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