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Analysis Suggests Oral Steroids are Better Than Intravenous Steroids for Treating MS

December 12, 2017

An analysis of five randomized trials suggests that oral steroids are cheaper, more convenient and less invasive than intravenous steroids for treating relapses in multiple sclerosis (MS) patients.

The first line of treatment recommended for MS relapses are glucocorticoids. Recent studies have found that there is no significant difference between oral methylprednisolone (a steroid) and intravenous methylprednisolone in terms of efficiency and safety.

Chinese researchers aimed to assess the clinical efficacy, safety and tolerability of oral versus intravenous methylprednisolone to treat MS relapses in the study, “Oral versus intravenous methylprednisolone for the treatment of multiple sclerosis relapses: A meta-analysis of randomized controlled trials.”

Five randomized, controlled trials were analyzed where 198 patients had received oral methylprednisolone, while 200 patients had received intravenous methylprednisolone. All patients in the trials had similar mean ages and the follow-up duration was between four and 24 weeks. No studies had reported significant differences between oral and intravenous groups in terms of clinical outcome improvement 28 days after relapse.

There were no significant differences observed between the two groups, however, patients in the oral group were more susceptible to insomnia than those in the intravenous group. As a result of this, the team recommends taking oral methylprednisolone in the morning.

While the study shows us a great deal, it does have some limitations. For example, the doses of methylprednisolone used in the studies were not identical and some studies did not necessarily use reliable randomization or binding methods. The team urges more large-scale randomized trials to be done in order to compare both methylprednisolone treatments in MS more accurately.

The team did come to the conclusion that the less expensive, less invasive and more convenient treatment of oral steroids may be a more effective alternative to intravenous steroids for the treatment of MS relapses.