Head-to-Head Comparison of IV and Oral Methylprednisolone for MS Relapses

Patients with a multiple sclerosis (MS) relapse affecting function and quality of life are offered intravenous (IV) methylprednisolone (MP), 1000 mg per day for 3 to 5 days, to hasten recovery. For cost and convenience reasons, some physicians prescribe oral (O) MP in an equivalent dose (i.e., prednisone 20 mg tablets, 20 tablets per day for 3 to 5 days). Data on relative efficacies have not been available.

In this multicenter, double-blind, placebo-controlled, randomized trial, researchers recruited 49 patients with moderate MS relapses. Treatment was IVMP at 1000 mg per day for 3 days or OMP at 1250 mg per day for 3 days. The study was 80% powered for noninferiority between the two preparations based on a 1-point difference on the Expanded…