Tolerance of intravenous methylprednisolone for relapse treatment in demyelinating CNS disease
BACKGROUND: In Switzerland, the first course of intravenous steroids for treatment of episodes of demyelinating CNS disease is usually administered in an inpatient setting. We prospectively evaluated short term tolerance of treatment with special emphasis on sleep quality. METHODS:...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2013-05-01
|
| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/1689 |
| _version_ | 1811194123358568448 |
|---|---|
| author | Carmen Lienert Gabriela Schawalder Oliver Findling Christian P Kamm Sebastian Humpert Anne Mugglin Johannes Mathis Mathias Sturzenegger Heinrich P Mattle |
| author_facet | Carmen Lienert Gabriela Schawalder Oliver Findling Christian P Kamm Sebastian Humpert Anne Mugglin Johannes Mathis Mathias Sturzenegger Heinrich P Mattle |
| author_sort | Carmen Lienert |
| collection | DOAJ |
| description |
BACKGROUND: In Switzerland, the first course of intravenous steroids for treatment of episodes of demyelinating CNS disease is usually administered in an inpatient setting. We prospectively evaluated short term tolerance of treatment with special emphasis on sleep quality.
METHODS: Patients with a first event of presumed demyelinating disease (CIS), multiple sclerosis relapses (MS) or sub-acute disease progression were treated with a 5-day regimen of intravenous methylprednisolone (IVMP) in our inpatient clinic. Patients’ experience was documented by self-report questionnaires including a standardised depression scale (ADSL). Laboratory tests were performed on a routine basis. Fasting glucose, blood pressure and pulse were measured before every infusion. Activity and sleep patterns were analysed by wrist actigraphs during the 5 day infusion period and at follow-up after 1–2 months.
RESULTS: A total of 66 patients participated in the study. Of these, 55 were steroid treatment naïve, and 11 patients, who had received intravenous steroid relapse treatment before, were admitted because of disabling symptoms. Mood disturbances were reported before steroid treatment, however significantly less often at the end of the steroid pulse and during follow-up. Sleep efficiency as measured by wrist actimetry was high before, during and after steroid treatment.
CONCLUSION: Therapy was well tolerated without severe side effects in CIS and MS patients. Sleep efficiency was not disturbed. In conclusion there are no obstacles to change from an inpatient to an outpatient setting for the steroid treatment of relapses in MS and CIS, but rare psychotic reactions to steroid treatment are not predictable.
|
| first_indexed | 2024-04-12T00:21:44Z |
| format | Article |
| id | doaj.art-db4e7cf5b267478cafb94edfa574f73b |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2024-04-12T00:21:44Z |
| publishDate | 2013-05-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-db4e7cf5b267478cafb94edfa574f73b2022-12-22T03:55:43ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972013-05-01143212210.4414/smw.2013.13783Tolerance of intravenous methylprednisolone for relapse treatment in demyelinating CNS diseaseCarmen LienertGabriela SchawalderOliver FindlingChristian P KammSebastian HumpertAnne MugglinJohannes MathisMathias SturzeneggerHeinrich P Mattle BACKGROUND: In Switzerland, the first course of intravenous steroids for treatment of episodes of demyelinating CNS disease is usually administered in an inpatient setting. We prospectively evaluated short term tolerance of treatment with special emphasis on sleep quality. METHODS: Patients with a first event of presumed demyelinating disease (CIS), multiple sclerosis relapses (MS) or sub-acute disease progression were treated with a 5-day regimen of intravenous methylprednisolone (IVMP) in our inpatient clinic. Patients’ experience was documented by self-report questionnaires including a standardised depression scale (ADSL). Laboratory tests were performed on a routine basis. Fasting glucose, blood pressure and pulse were measured before every infusion. Activity and sleep patterns were analysed by wrist actigraphs during the 5 day infusion period and at follow-up after 1–2 months. RESULTS: A total of 66 patients participated in the study. Of these, 55 were steroid treatment naïve, and 11 patients, who had received intravenous steroid relapse treatment before, were admitted because of disabling symptoms. Mood disturbances were reported before steroid treatment, however significantly less often at the end of the steroid pulse and during follow-up. Sleep efficiency as measured by wrist actimetry was high before, during and after steroid treatment. CONCLUSION: Therapy was well tolerated without severe side effects in CIS and MS patients. Sleep efficiency was not disturbed. In conclusion there are no obstacles to change from an inpatient to an outpatient setting for the steroid treatment of relapses in MS and CIS, but rare psychotic reactions to steroid treatment are not predictable. https://www.smw.ch/index.php/smw/article/view/1689intravenous steroid treatmentMultiple sclerosissleep/activity pattern |
| spellingShingle | Carmen Lienert Gabriela Schawalder Oliver Findling Christian P Kamm Sebastian Humpert Anne Mugglin Johannes Mathis Mathias Sturzenegger Heinrich P Mattle Tolerance of intravenous methylprednisolone for relapse treatment in demyelinating CNS disease Swiss Medical Weekly intravenous steroid treatment Multiple sclerosis sleep/activity pattern |
| title | Tolerance of intravenous methylprednisolone for relapse treatment in demyelinating CNS disease |
| title_full | Tolerance of intravenous methylprednisolone for relapse treatment in demyelinating CNS disease |
| title_fullStr | Tolerance of intravenous methylprednisolone for relapse treatment in demyelinating CNS disease |
| title_full_unstemmed | Tolerance of intravenous methylprednisolone for relapse treatment in demyelinating CNS disease |
| title_short | Tolerance of intravenous methylprednisolone for relapse treatment in demyelinating CNS disease |
| title_sort | tolerance of intravenous methylprednisolone for relapse treatment in demyelinating cns disease |
| topic | intravenous steroid treatment Multiple sclerosis sleep/activity pattern |
| url | https://www.smw.ch/index.php/smw/article/view/1689 |
| work_keys_str_mv | AT carmenlienert toleranceofintravenousmethylprednisoloneforrelapsetreatmentindemyelinatingcnsdisease AT gabrielaschawalder toleranceofintravenousmethylprednisoloneforrelapsetreatmentindemyelinatingcnsdisease AT oliverfindling toleranceofintravenousmethylprednisoloneforrelapsetreatmentindemyelinatingcnsdisease AT christianpkamm toleranceofintravenousmethylprednisoloneforrelapsetreatmentindemyelinatingcnsdisease AT sebastianhumpert toleranceofintravenousmethylprednisoloneforrelapsetreatmentindemyelinatingcnsdisease AT annemugglin toleranceofintravenousmethylprednisoloneforrelapsetreatmentindemyelinatingcnsdisease AT johannesmathis toleranceofintravenousmethylprednisoloneforrelapsetreatmentindemyelinatingcnsdisease AT mathiassturzenegger toleranceofintravenousmethylprednisoloneforrelapsetreatmentindemyelinatingcnsdisease AT heinrichpmattle toleranceofintravenousmethylprednisoloneforrelapsetreatmentindemyelinatingcnsdisease |