Tag Archives: Methylprednisolone

Other Off-Label Agents Used in the Treatment of RRMS

Corticosteroids Corticosteroids are considered as standard treatment for acute relapses. Corticosteroids decrease inflammation and stabilize the blood brain barrier, resulting in more rapid recovery from relapses. The standard dose is 1 g of methylprednisolone (MP) daily for 3-5 days through I/V infusion, although other regimens also have been used. Some studies have suggested that oral… Read More »

Combination Therapy in Multiple Sclerosis

The treatment of multiple sclerosis (MS) has been revolutionalized over the past decade. Just 12 years ago, multiple sclerosis was not considered a treatable neurologic illness and our therapeutic armamentarium consisted largely of symptomatic therapies and corticosteroids to treat acute exacerbations. Currently, there are five drugs [the three beta interferons (IFNs) (Avonex®, Betaseron®, and Rebif®),… Read More »

Therapy in Multiple Sclerosis: IFN, Methylprednisolone, and Methotrexate

Corticosteroids have anti-inflammatory and immunosuppressive properties and have been used to treat acute multiple sclerosis exacerbations for more than 30 years. While periodic pulses of intravenous (IV) methylprednisolone are not effective in preventing disability in patients with progressive MS, a phase II trial concluded that they do have an effect on disability, brain atrophy, and… Read More »

Mitoxantrone in Multiple Sclerosis

Mitoxantrone () was developed in the 1970s and is an antineoplastic agent. It is an anthracenedione derivative related to the anthracyclins doxorubicine and daunorubicine. It interacts with topoisomerase-2, stabilizes its cleavable complex with DNA, thus prevents the ligation of DNA strands, and consecutively delays the cell-cycle progression. Mitoxantrone is used to effectively treat malignancies such… Read More »

Acute Treatments

Most patients with multiple sclerosis (MS) experience relapses characterized by acute or subacute neurological dysfunction lasting days to several weeks followed by a remission with partial or complete resolution of neurological dysfunction. Attacks may occur as part of diverse demyelinating syndromes: clinically isolated syndromes [e.g., isolated optic neuritis (ON), myelitis, or brainstem syndromes], relapsing-remitting multiple… Read More »

Treatment With Corticosteroids

It is common practice to prescribe high-dose methylprednisolone for treatment of acute relapses. methylprednisolone binds to albumin and glucocorticosteroid-binding globulin at low-doses. The blood-brain barrier has limited permeability to these protein complexes. high-dose methylprednisolone, however, saturates the binding proteins and has higher free levels in serum, thereby facilitating its crossing the blood-brain barrier. Methylprednisolone reduces… Read More »

Therapeutic Plasma Exchange

High-dose corticosteroids are the treatment of choice for acute demyelinating attack given their well-proven efficacy, as described above, and their ease of administration and cost. Therapeutic plasma exchange may be a valuable treatment for patients who fail to respond to steroids. This section focuses on the use of therapeutic plasma exchange in acute attacks of… Read More »

Acute Treatment: Mitoxantrone

Several class II and III studies suggest a role for mitoxantrone in treatment of worsening relapsing-remitting multiple sclerosis or secondary progressive multiple sclerosis. mitoxantrone has been approved for treatment of worsening RRMS, secondary progressive MS, and progressive relapsing multiple sclerosis. Mitoxantrone is an antineoplastic agent that has been used for prostate cancer and nonlymphocytic leukemia… Read More »

Acute Treatment: Cyclophosphamide

Cyclophosphamide is an alkylating agent with immunosuppressive properties and is commonly used in treatment of immune-mediated disease. The role of cyclophosphamide in multiple sclerosis has been studied extensively, and the current literature supports its use in active inflammatory demyelination. Uncontrolled data suggests that cyclophosphamide may be an effective alternative for treatment of rapidly worsening multiple… Read More »

Treatment Of Breakthrough Disease

There is consensus that therapy in relapsing-remitting multiple sclerosis (MS) in the pediatric age group should be initiated with first-line treatments approved for adult multiple sclerosis (MS), namely one of the three forms of interferon-beta or glatiramer acetate (GA). However, as in adults with multiple sclerosis (MS), the disease remains clinically or radiologically active in… Read More »