Multiple sclerosis (MS): treatment of relapses

Treatment of acute MS relapses

• Oral Methylprednisolone 0.5 g daily for 5 days.
• Intravenous Methylprednisolone 1 g daily for 3-5 days

Indications for intravenous steroid treatment

Treatment of relapses in secondary progressive MS (SPMS)

Comparison of oral and intravenous steroids

Methylprednisolone-induced acute liver injury in treatment of relapses

References

1. Rejdak K, Jackson S, Giovannoni G. Multiple sclerosis: a practical overview for clinicians. Br Med Bull 2010; 95:79-104.
2. Multiple sclerosis: management of multiple sclerosis in primary and secondary care. NICE clinical guidelines [CG186]. October 2014.
3. Perry M, Swain S, Kemmis-Betty S, Guideline Development Group of the National Institute for Health and Care Excellence. Multiple sclerosis: summary of NICE guidelines. BMJ 2014; 349:g5701.
4. Hervás-García JV, Ramió-Torrentà L, Brieva-Ruiz L, et al. Comparison of two high doses of oral methylprednisolone for multiple sclerosis relapses: a pilot, multicentre, randomized, double-blind, non-inferiority trial. Eur J Neurol 2019; 26:525-532.
5. Scolding N, Barnes D, Cader S, et al. Association of British Neurologists: revised (2015) guidelines for prescribing disease-modifying treatments in multiple sclerosis. Pract Neurol 2015; 15:273-279.
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Related checklists

• Multiple sclerosis (MS): symptomatic treatments
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