engleski

The effect of ACTH and corticosteroid therapy on the progression of disability in multiple sclerosis

Objective: To investigate the influence of the ACTH and corticosteroid therapy on the progression of disability in multiple sclerosis (MS) patients. Material and methods: A group of 124 clinically definite MS patients from Croatia was postmortem divided in two subgroups, depending on wether they had or had not received ACTH or corticosteroid therapy during the MS relapses. The patients from the each subgroup were further divided depending on wether they came from disease high- or low- risk area. Corticotropin was administered intravenously (i.v.) in dose of 100 units a day during the first week, 75 units a day during the second, 50 units a day during the third and 25 units a day during the fourth week of therapy. Methylprednisolone sodium succinate was administered in dose of 0, 5 gram i.v. daily for 5-7 days. EDSS was used in assessment of patients' disability. The result were evaluated by t-test for independent samples, p-values less than 0, 05 were considered statistically significant. Results: ACTH or corticosteroids treated MS patients developed moderate (EDSS <4) as well as severe (EDSS 4-8) disability before non-treated patients (p<0, 05). In excepton for ACTH or corticosteroids treated group in reaching the moderate disability, patients (ACTH or corticosteroids treated and those non treated) from the low risk area developed moderate as well as severe disability before those from the high-risk area. Conclusion: MS patients on ACTH or corticosteroid therapy during the MS relapses showed significantly faster disability progression in comparison to the non-treated. This was much more remarkable among the patients from the disease low-risk area.

ACTH; corticosteroides; disability; multiple sclerosis; progression; therapy

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