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MS Patients Report Excellent Compliance with Oral Prednisone for Acute Relapses

Published online by Cambridge University Press:  02 December 2014

Sarah A. Morrow ,
Lynn McEwan ,
Katayoun Alikhani ,
Christopher Hyson  and
Marcelo Kremenchutzky
Sarah A. Morrow*
Affiliation:
University of Western Ontario, London, Ontario
Lynn McEwan
Affiliation:
University of Western Ontario, London, Ontario
Katayoun Alikhani
Affiliation:
Multiple Sclerosis Clinic, Foothills Hospital, Calgary, Alberta, Canada
Christopher Hyson
Affiliation:
University of Western Ontario, London, Ontario
Marcelo Kremenchutzky
Affiliation:
University of Western Ontario, London, Ontario
*
University of Western Ontario, LSHC-UH B10-118, 339 Windermere Rd, London, Ontario, N6G 1W8, Canada. Email: smorrow8@uwo.ca
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Abstract

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Background:

Multiple Sclerosis is characterized by relapses separated by periods of relative quiescence. High dose intravenous corticosteroid pulses for three to five days is the current standard for the treatment of acute relapses, but recent evidence supports the use of equivalent doses of oral therapy as an alternative. The highest single dose preparation of oral prednisone is a 50mg tablet, requiring patients to take 25 tablets a day. Questions regarding compliance with this oral regimen have been raised.

Objectives:

To determine whether MS patients are complaint with 1250mg of oral prednisone daily for acute relapses.

Methods:

Between November 2008 and December 2009, all patients diagnosed with an acute relapse in the London (Ontario) MS clinic were prospectively identified. If treatment with oral prednisone was initiated, subjects were given a survey to be mailed anonymously to the clinic.

Results:

Sixtyeight MS relapses were diagnosed and treated with corticosteroids in 66 patients of which 60 (58 subjects) were treated with 1250mg prednisone. Fifty-three (91.4%) surveys were returned. The reported compliance rate was high at 94.3% (50/53) with only one patient reporting being unable to take all the required pills due to intolerance. Most subjects (43, 86.0%) encountered at least one side effect, most commonly insomnia, mood changes and increased appetite. Two thirds of subjects (69.8%) indicated a preference for oral medication for future relapses.

Conclusion:

High dose (1250mg) oral prednisone is an acceptable therapy to MS patients for the treatment of acute relapses with a high rate of compliance.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 39 , Issue 3 , May 2012 , pp. 352 - 354
Copyright
Copyright © The Canadian Journal of Neurological 2012

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