Oral vs IV Steroids During Relapses

[Marco]

Q. Is there any difference between oral and intravenous methylprednisolone for multiple sclerosis relapses?


A. When relapses of multiple sclerosis occur, studies have shown that intravenous steroids are the treatment of choice. Prior Cochrane meta-analyses have not found any significant difference between intravenous and oral treatments; however, the studies all have had limitations. This study was designed to provide a statistically significant answer.




http://www.the-hospitalist.org/artic...osis-relapses/

[jreagan70]

To spare everyone from having to read through the report, this is yet another study showing that there's no significant difference between oral and IV steroids (at similar dosage) in treating MS relapses.

"Bottom line: Consider using oral instead of IV steroids in patients with relapsing multiple sclerosis."

I've been taking high-dose oral prednisone instead of IVSM for years now.

[Cat Mom]

I tried oral (same dose as IV) on my second flare and 10 years later still have no vision in my left eye. I would have gone IV but I was new at my job and didn't want to be off work. I say IV all the way, plus the oral did my stomach in.
Jen

[jreagan70]

I tried oral (same dose as IV) on my second flare and 10 years later still have no vision in my left eye. I would have gone IV but I was new at my job and didn't want to be off work. I say IV all the way, plus the oral did my stomach in.
Jen

Hi Jen:

You're assuming that if you'd had IV steroids instead of oral, the outcome would have been different. It can't be said with 100% certainty. But numerous studies have shown not only that there's no significant outcome between oral and IV steroids, studies have shown that there's no difference in outcome between being treated with steroids and not being treating at all.

That means that the outcome -- no vision in your left eye -- would have been the same even if you had been treated with IV steroids. It isn't the type of steroid -- or steroids at all -- that made a difference in your outcome. So your belief that IV steroids over oral would have made a difference is nothing but an unfounded assumption.

That's the beauty of controlled clinical studies. They're repeatable and cut through the assumptions and imaginary outcomes.