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Abstract

COMPARISON BETWEEN LOW DOSE AND HIGH DOSE INTRAVENOUS METHYLPREDNISOLONE FOR TREATMENT RELAPSES OF MULTIPLE SCLEROSIS IN IRAQI PATIENTS

Zainab Ali Abbood, May Siddik Al-Sabbagh, Hassan Mohammed Abbas Al-Temimi

ABSTRACT

Background: Multiple Sclerosis, a chronic inflammatory and neurodegenerative disease of the central nervous system, characterized by recurrent relapses of central nervous system inflammation ranging from mild to severely disabling. Relapses have treated with steroids to reduce inflammation and hasten recovery. However, the commonly used intravenous methylprednisolone in a dose 500mg_1000mg for 5days. Objectives: The possible effect of use low dose intravenous methylprednisolone (500mg) against stander dose (1000mg) for treatment of patients with relapses of multiple sclerosis. Methods: A prospective case controlled study was carried on 40 patients who had multiple sclerosis relapse confirmed by kuratzke expanded disability status scale. Patients were divided into 2 groups first group involved 20 patients treated with (500 mg IV methylprednisolone) for 5 days. The second group involved 20 patients treated with (1000mg IV methylprednisolone) for 5days. Expanded disability status score, random blood sugar, blood urea nitrogen and serum creatinine before and after 1 and 6 weeks of the study. Results: The results showed that significant decreased in expanded disability status score, (p<0.05) and increase in recovery percentage after one and six weeks of treatment with 500mg and 1000mg IV methylprednisolone for 5 days in comparison with pretreatment. Regarding blood urea nitrogen and serum creatinine there were non-significant difference between both groups. Conclusion: It seems from this short study that methylprednisolone in a dose of 500mg (IV) daily for 5day to patient with multiple sclerosis could have the same therapeutic effect than a dose of 1000mg (IV) for 5 days, with lower side effect.

Keywords: Multiple Sclerosis (MS), methylprednisolone, Expanded Disability Status Score (EDSS).


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