Baseline clinical status as a predictor of methylprednisolone response in multiple sclerosis relapses

Abstract

Background: To date, there are no available factors to predict the outcome after multiple sclerosis relapse.

Aim: To investigate factors that may be useful for predicting response to methylprednisolone treatment, following a relapse of multiple sclerosis (MS).

Methods: The study included 48 MS patients enrolled in a double-blind multicenter trial to receive intravenous versus oral high-dose methylprednisolone treatment. Associations were sought between the disability status prior to relapse and the relapse severity, determined by changes in the Expanded Disability Status Scale (EDSS) score, as well as the improvements after treatment. We also analyzed the relationships between the number of magnetic resonance imaging (MRI) gadolinium-enhancing lesions (Gd+) and improvement.

Results: A higher EDSS score before relapse was associated with more severe relapses (p = 0.04) and less marked improvement (odds ratio (OR) 1.8; 95% CI (1.2-2.2); p = 0.05) after methylprednisolone treatment. Relapse severity (p = 0.29) and the number of Gd+ lesions at relapse (p = 0.41) were not related with improvement.

Conclusions: Clinical baseline status prior to MS relapse is a predictor of response to methylprednisolone treatment.

Trial registration: ClinicalTrials.gov NCT00753792.

Keywords: Disability; methylprednisolone; multiple sclerosis; relapse.