More than half of patients with relapsing-remitting multiple sclerosis (MS) develop a progressive illness in about 10 to 15 years (secondary progressive MS), and 10% to 15% of all patients with MS enter the progressive stage from onset (primary progressive MS). After a patient reaches level 4 on the Expanded Disability Status Scale,1 the rate of progression becomes identical in primary and secondary progressive cases. This suggests a common mechanism for progression, which may be related to axonal abnormalities. For progressive forms of MS, unless they are associated with rapid progression and evidence of inflammation, there is no accepted treatment. In our experience, a subset of patients with progressive MS shows an objective and measurable response to intravenous methylprednisolone sodium succinate (IVMP) treatment. The aim of this letter is to report the effects of pulsed IVMP therapy given for years in a subset of patients with progressive MS.
Pirko I, Rodriguez M. Pulsed Intravenous Methylprednisolone Therapy in Progressive Multiple Sclerosis: Need for a Controlled Trial. Arch Neurol. 2004;61(7):1148-1149. doi:10.1001/archneur.61.7.1148