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September 1989

Corticotropin Is Superior to Corticosteroids in the Treatment of MS

Author Affiliations

Neurological Unit Beth Israel Hospital 330 Brookline Ave Boston, MA 02215

Arch Neurol. 1989;46(9):946. doi:10.1001/archneur.1989.00520450016008

To the Editor.  —I wish to add my strong concurrence to the excellent and important letter by Drs Davis and Stefoski in the November 1988 issue of the Archives.1It has also been my experience for the past 15 years or more, that corticotropin is indeed superior to corticosteroids in the treatment of acute exacerbations of multiple sclerosis. In fact, I have been using the "synthetic" corticotropin, cosyntropin, intravenously in a regimen of 1.0 mg daily for 10 days. The advantage of this regimen is that it requires neither tapering nor posttreatment oral corticosteroids. My own experience with intravenous methylprednisolone has been that, while it is undeniable that a number of patients show a very rapid response, posttreatment oral corticosteroids are required; thus I am not convinced that the end results using just the oral corticosteroids are not just as good as the intravenous pulses of methylprednisolone.It has

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