5th Joint triennial congress of the European and Americas Committees
for Treatment and Research in Multiple Sclerosis
Amsterdam, The Netherlands

19.10.2011 - 22.10.2011
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Home - 21.10.2011 - Long-term treatment monitoring 2

Long-term treatment monitoring 2

Friday, October 21, 2011, 15:30 - 17:00

Intravenous and oral steroids may be insufficient for treating relapses in a significant proportion of patients with multiple sclerosis: patient experiences collected by NARCOMS

M. Nickerson, R. A. Marrie (Hayward, US; Winnipeg, CA)

Of these 4485 participants, 3628 (81%) were female and 854 (19%) were male. Ages ranged from 20 to 90 with the greatest number being in the 45-54 age group. 2915 (67%) of participants reported a relapse within 12 months prior to the survey, 3879 (89%) reported a relapse within 24 months, while the remaining 488 (11%) reported that their last relapse was over 24 months earlier. Based on management of their last relapse, nearly half (n = 2105) were treated with corticosteroid therapy (oral; n=913 or IV; n=1192). 32% of intravenous methylprednisolone (IVMP)-treated and 33% of oral corticosteroid-treated patients indicated that their symptoms were still worse one month after treatment than pre-relapse baseline. Of those who were simply observed during relapse (n=1574, 36%), 39% said that their symptoms were worse one month post-relapse compared to baseline.
When asked whether treatment affected relapse recovery, 30% of IVMP-treated patients reported that their treatment worsened their relapse symptoms or had no effect (13% worse, 17% no effect). 39% of oral steroid-treated patients indicated that the treatment worsened their relapse symptoms or had no effect (13% worse, 26% no effect). Among untreated patients, 17% reported relapse symptom worsening and 59% reported no change in symptoms. Factors such as number of relapses, site of treatment administration, gender and disease duration were also explored.
Following corticosteroid treatment, a significant proportion of patients with RRMS felt their symptoms were worse than pre-relapse, similar to patients who were not treated. Furthermore, treatment with corticosteroids either had no effect or worsened relapse symptoms in over 30% of patients. Taken together, these data indicate that in order to mitigate the severity of relapses and improve patient quality of life, it may be necessary to consider alternatives to corticosteroids in relapsing patients who do not adequately respond to such treatment. Self-reported and objective measures evaluating the therapeutic response, adverse effect profile, and patient quality of life following alternative relapse treatment regimens are warranted, and may lead to improved relapse management.

M. Nickerson is an employee of Questcor Pharmaceuticals. Funding for this research was provided by Questcor Pharmaceuticals. R. A. Marrie has no conflict of interest to report.