High doses of intravenous steroids are recommended to treat relapses in people with multiple sclerosis. However intravenous administration is expensive, not easily accessible to all and can be painful and invasive.
A French research team led a clinical trial between 2008 and 2013 to compare the effectiveness of oral administration of high-dose steroids to intravenous administration.
199 patients were randomly split into two groups with one group receiving oral steroids and the other receiving intravenous steroids.
The results showed that high doses of oral steroids was non-inferior to intravenous steroids in improving disability scores 28 days after a relapse.
The tolerability was similar for both types of steroid administration, except for insomnia which was more frequent in the oral group than in the intravenous group.
The data from this trial support the use of oral steroid methylprednisolone to treat MS relapses. The recommended dosage is 1000mg per day for 3 days to be administered in the morning to reduce the appearance of insomnia.
This finding could have implications for access to treatment, comfort, and cost of the management of MS relapses.
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