Abstract Details

Title Delayed Steroid Treatment Can Be Beneficial in Multiple Sclerosis Patients with Severe Sequelae

Topic MS and Related Diseases

Presentation(s) P01 - (-)

Poster/Presentation
Number 201

Objective

Background BACKGROUND: High dose intravenous methylprednisolone is the most used therapy for relapse of MS patients. Steroids can affect the immune system, reducing the IFN-? secretion and increasing chemokines expression. It has been showed that a shorter lapse of time between onset of symptoms and treatment is related to a better outcome. Nevertheless, to date no studies have explored the effect of steroids administered in MS patients months after the onset of symptoms.

Design/Methods DESIGN/METHODS: We identified 380 patients diagnosed with MS in our Neurology Department between 1st of January 2007 and 31st of December 2011. 22 patients received treatment 3-10 months after the onset of symptoms (group A), while 14 patients after 10 months (group B). EDSS score was calculated at the baseline and 6 months (T1) and 12 months (T2) after treatment. ANOVA for repeated measures with a Bonferroni correction for multiple comparison was performed to assess the differences between timepoint. A logistic regression model was fit, to assess the association between EDSS improvement and lapse of time between onset of symptoms and treatment.

Results RESULTS: In group A we found a significant difference in term of EDSS score between T0 vs T1 (p<0.05) and T0 vs T2 (p<0.05). In group B we found a significant difference between T0 vs T1 (p<0.05). A logistic regression model showed EDSS improvement at T1 is independent of lapse of time between onset of symptoms and treatment (OR 1.02, CI 0.99-1.05).

Conclusions CONCLUSIONS: Regardless the lapse of time between the onset of symptoms and treatments, steroids are effective in RRMS patients. Further studies are needed to better understand the effect of steroids on the immune system.

Authors/Disclosures
Francesco Patti, MD PRESENTER	Dr. Patti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Almirall. Dr. Patti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Meyers. Dr. Patti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Johnson and Johnson. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. Dr. Patti has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Almirall, Bayer, Biogen, Bristol Meyers and Squibb Merck, Roche, Sanofi, TEVA. Dr. Patti has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for University of Catania and AISM/FISM, Fondazione Italiana Sclerosi Multipla. Dr. Patti has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Frontiers in Neurology.
Silvia Messina (AOU Policlinico Vittorio Emanuele)	No disclosure on file
Emanuele D'Amico	Emanuele D'Amico has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Clara Chisari, MD	Clara Chisari, MD has nothing to disclose.
Mario Zappia, MD (Università Degli Studi Di Catania- Dept of Medical & Surgical Sciences)	No disclosure on file
Robert Stern, PhD (Boston University School of Medicine)	Robert Stern, PhD has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. The institution of Robert Stern, PhD has received research support from Eisai. The institution of Robert Stern, PhD has received research support from Lilly. The institution of Robert Stern, PhD has received research support from ATRI/NIA. Robert Stern, PhD has received publishing royalties from a publication relating to health care. Robert Stern, PhD has a non-compensated relationship as a Member with NFLPA Mackey-White Committee that is relevant to AAN interests or activities.

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