University of Cagliari

Author Of 1 Presentation

Patient-Reported Outcomes and Quality of Life Poster Presentation

P1003 - A cohort analysis of MS patients exposed to high-dose corticosteroids (ID 768)

Speakers
Presentation Number
P1003
Presentation Topic
Patient-Reported Outcomes and Quality of Life

Abstract

Background

Corticosteroids in high dose (HDC) is the recommended treatment for multiple sclerosis (MS) relapses. Most common first line treatment consists of three to five days courses of 1 g of intravenous methylprednisolone. The choice of HDC duration varies due to different clinical considerations.

Objectives

Our aim was to determine which demographic factors, comorbidities and MS clinical considerations led to the choice of a longer or shorter HDC course duration, also exploring the possible effect on clinical benefit reported by treated patients after one month.

Methods

MS subjects with a clinical relapse of MS or with MRI activity who underwent a treatment with HDC were enrolled. Demographics (sex and age), clinical features (type of relapse and EDSS) and medical history (occurrence of metabolic, immune and psychiatric comorbidities) were collected prior to HDC. After a month, subjective clinical benefit was also evaluated. Regression models were used to evaluate the relationships of HDC duration and clinical benefits after 1 month with demographic and medical variables.

Results

101 MS patients were enrolled (mean age 44 years, male 24.8%, mean EDSS 3.1). Most of them (92.1%) had a clinical relapse (31.1% with multisystem involvement), 7.9% only had brain MRI activity. 66.3% were on DMDs. 36.6% had comorbidities (autoimmune comorbidities 16.8%) and 45.8% had mood disorder. Linear regression showed that older age (p 0.039) and psychiatric comorbidities (p 0.019) correlate with the choice of shorter HDC treatment (3 days). Conversely, multisystem deficit relapses correlate with the choice of longer treatment (5 days) (p 0.001). Subjective clinical benefit after one month was only associated with EDSS score pre HCD treatment (p 0.004), while no association was reported with number of days of treatment.

Conclusions

Data suggests that some clinical factors, such as severity of relapse, age and comorbidities can affect the choice of HDC course duration. Shorter HDC treatments in selected patients appear to be an appropriate treatment option that does not affect the reported clinical benefit.

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