Corticosteroids in the management of acute multiple sclerosis exacerbations

Acta Neurologica Belgica - Tập 117 - Trang 623-633 - 2017
I. Smets1, L. Van Deun2, C. Bohyn3, V. van Pesch4, L. Vanopdenbosch5, D. Dive6, V. Bissay2, B. Dubois1
1Department of Neurology, University Hospitals Leuven, Louvain, Belgium
2Department of Neurology, University Hospitals Brussels, Jette, Belgium
3Department of Radiology, University Hospitals Leuven, Louvain, Belgium
4Department of Neurology, Cliniques Universitaires Saint-Luc, Sint-Lambrechts-Woluwe, Belgium
5Department of Neurology, Hospital AZ Sint-Jan, Brugge, Belgium
6Neuroimmunological and Rehabilitation Unit, University Hospitals Liège, Liège, Belgium

Tóm tắt

Multiple sclerosis (MS) is an autoimmune, inflammatory demyelinating disease of the central nervous system characterized in the majority of the patients by a relapsing-remitting disease course. For decades high-dosage corticosteroids (CS) are considered the cornerstone in the management of acute MS relapses. However, many unanswered questions remain when it comes to the exact modalities of CS administration. In this review on behalf of the Belgian Study Group for MS we define the efficacy of CS in reducing MS-related morbidity and examine whether the effect is different according to type of CS, route of administration, cumulative dosage, timing of initiation and disease course. We also review the use of CS in combination with other MS treatments and during pregnancy and lactation. Furthermore, we delineate the relevant adverse events due to a pulse CS regimen and present a decision tree that can be used when treating MS relapses in clinical practice.

Tài liệu tham khảo

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