Intravenous Solumedrol vs Oral Prednisone Steroids for an MS Relapse

What’s the best way to treat an MS relapse? My neurologist has long said it makes little difference in treating an MS relapse if we are given a course of IV Solumedrol (IVSM) over several days or if we take an oral form of prednisone or decadron, a compounded formula. Research presented at the recent ECTRIMS/ACTRIMS Congress – that’s the European and American Committees for Treatment in Multiple Sclerosis – supports that thought. In a presentation titled Efficacy and safety of oral versus intravenous high-dose methylprednisolone in multiple sclerosis relapses, a randomized double blind trial (COPOUSEP), a group of researchers from France looked at the this question and came to the conclusion that there is no statistical advantage of doing one form of treatment over the other. The benefits and the side effects were virtually identical.

How did they come to these results? Their study looked at 200 people with MS who were having a relapse and participated in a double-dummy study, where each person was given both an IV and oral treatment, but only one of them contained an active drug. After the treatment, each participant was followed to see how their relapse resolved. They found statistically there was no real difference between the two treatments.

There is more than one reason why this is significant news. First, for the person experiencing the relapse, being treated at home by taking a handful of pills for 3-5 days, is simpler than going to an infusion center each day. It might take several minutes to swallow all those pills, but it is still faster than traveling to an infusion center, sitting in that chair for about an hour, and the heading out.

Secondly, as hard as it is to swallow those pills, as I wrote about recently in MS Relapse & Steorids: Five Long Days, it is still the preferable treatment method  for most of us over being stuck by a needle again and again. This is especially true if you are already on an injectable therapy and feeling like a pin cushion from the repeated injections.

Next, there is a significant economic difference between having an infusion and taking pills. If you work, there is no need to take time off to go to the infusion center for the treatment. Some people have their relapse treatment done as patients in a hospital setting and that can quickly escalate the cost of treatment.

There is a big difference between the costs of these drugs as well. Prednisone pills are significantly less than the price of IVSM and the associated costs of equipment and medical people to assist with the infusion. Any form of medical treatment that costs us less time and money is a good thing, right?  MS is an expensive disease to live with and any way we can find to contain those costs, is good.

This study is good news that I hope all of our neurologists hear/read these results and will offer oral treatment as an option for MS relapses.

Wishing you well,

Laura

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