The effect of oral corticosteroid dosage on CT enhancing multiple sclerosis plaques

Troiano, Raymond; Hafstein, Marino P.; Zito, George; Ruderman, Marvin I.; Dowling, Peter C.; Cook, Stuart D.

doi:10.1016/0022-510x(85)90188-1

Cited by 16 publications

(3 citation statements)

References 14 publications

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“…• anti-inflammatory/anti-oedema effects, with reduction of blood-brain barrier defects and interstitialoedema [33,34] • metabolic/physiological effects that lead to improved axonal conduction shortly after infusion [35] • immunomodulatory effects. The immunomodulatory effects are numerous and only partly understood.…”

Section: Background and Potential Mechanism Of Actionmentioning

confidence: 99%

Immunotherapy for Multiple Sclerosis

Kinkel

Goodkin²

1994

Clin. Immunother.

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Section: Background and Potential Mechanism Of Actionmentioning

confidence: 99%

Immunotherapy for Multiple Sclerosis

Kinkel

Goodkin²

1994

Clin. Immunother.

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“…Evidence suggests that plaque edema, as measured by computed tomography (CT) of the brain, is reduced more effectively by administering steroids at high doses (1.5 g methylprednisolone [MP] intravenously [IV]) rather than at low doses. 2,3 However, no correlation has been shown between clinical status and breakdown of the blood-brain barrier as evident by CT scan.…”

Section: Mechanisms Of Actionmentioning

confidence: 99%

Pharmacotherapy of multiple sclerosis: current status

Rudick

Goodkin

Ransohoff

1992

Cleveland Clinic Journal of Medicine

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Pharmacotherapy plays an important part in the overall management of patients with multiple sclerosis. Most therapies directed at altering the natural history of the underlying disease process are only partially effective or are controversial or experimental. However, many effective symptomatic therapies are available to the clinician. The action and uses of corticosteroids in multiple sclerosis are discussed, and approaches to the treatment of spasticity, paroxysmal disorders, bladder dysfunction, cerebellar ataxia, neurobehavioral manifestations, fatigue, and acute and chronic pain in patients with multiple sclerosis are examined.

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“…One can argue the need for higher therapeutic levels of glucocorticoids for disorders affecting the central nervous system, as has been shown in certain neurological disorders such as multiple sclerosis and transverse myelitis, before therapeutic benefits can be realised. 21 Why does glucocorticoid action have a potentially significant beneficial role in acute SCI? Glucocorticoids are among the most potent anti-inflammatory agents ever discovered.…”

mentioning

confidence: 99%

The experimental basis for early pharmacological intervention in spinal cord injury

1991

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The major impetus of basic spinal cord injury (SCI) research is that therapeutic interventions can be devised to prevent or reduce disability. For years, there was doubt about the prospect that any effective treatment could ever be developed. This view is based primarily on the notion that once spinal cord trauma has occurred, the damage is done and outcome is determined at the moment of impact. The potential for any therapeutic intervention to reverse the injury process or to reduce the damage has been, understandably, doubtful. Numerous therapeutic interventions had claimed to be successful in animal models, yet none had been confirmed in patients with SCI. Recently, however, the Second National Spinal Cord Injury Study (NASCIS II) has altered such pessimistic viewpoints.1 This study is a landmark achievement in pharmacological intervention of SCI. For the first time, a multicentre placebo-controlled, double-blind trial, using a well designed protocol and sound statistical analysis, shows that an acute traumatic insult to the spinal cord is treatable if an appropriate therapeutic agent is administered within a therapeutic window. NASCIS II was based on earlier elegant investigations in animal models that showed methylprednisolone, a glucocorticoid, to be effective in ameliorating vascular, metabolic, pathological, and functional consequences of traumatic SCI. 2 -9 Confirmation of the animal studies in a human trial using a rigorously designed protocol has significant laboratory and clinical implications. It establishes the precedent that the therapeutic success of SCI models in animals can be duplicated in patients with a similar disorder. It also diminishes the pessimism concerning the applicability of animal models to human diseases affecting the central nervous system, in particular, central nervous system (CNS) trauma.10. II The success of NASCIS II also legitimises therapeutic trials in animal models of SCI. Research projects exclusively devoted to therapeutic trials in animal models are usually not considered to be meritorious by review panels from various funding agencies. The

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The effect of oral corticosteroid dosage on CT enhancing multiple sclerosis plaques

Cited by 16 publications

References 14 publications

Immunotherapy for Multiple Sclerosis

Immunotherapy for Multiple Sclerosis

Pharmacotherapy of multiple sclerosis: current status

The experimental basis for early pharmacological intervention in spinal cord injury

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