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Methylprednisolone effect on brain volume and enhancing lesions in MS before and during IFNβ-1b

2002; Lippincott Williams & Wilkins; Volume: 59; Issue: 5 Linguagem: Inglês

10.1212/wnl.59.5.688

1526-632X

Archana Rao, Nancy Richert, T. Howard, Bobbi K. Lewis, C. Bash, Henry F. McFarland, Joseph A. Frank,

RNA regulation and disease

Objective: To determine the effect of IV methylprednisolone (IVMP) on brain fraction volume (BFV), contrast-enhancing (CE) lesions, and white matter lesion load (WMLL) in patients with relapsing-remitting MS treated for acute exacerbations. Background: MRI metrics of MS disease activity are being used as outcome measures in early phase treatment trials, however the short-term effects of IVMP treatment on cerebral atrophy are unknown. Methods: Serial monthly MRI were performed in 26 patients enrolled in a baseline vs treatment trial with interferon β-1b (IFNβ-1b) who were followed for 3 months before and after IVMP. All 26 patients were evaluated while receiving IFNβ-1b, and 12 patients were also studied during the baseline stage of the trial (NHx). Acute exacerbations were treated with IVMP (1 g/d) for 3 to 5 days. Precontrast and postcontrast T1-weighted and proton density T2-weighted fast spin-echo images were analyzed. Results: Fifty-six acute exacerbations were evaluated. For the 3 months before IVMP, there was no difference in WMLL or BFV compared to month IVMP was administered. There was a significant decrease in BFV at month 1 after IVMP in the IFNβ-1b and NHx groups. Compared to the month IVMP was administered, there was a difference in the CE lesions for months −3 and −1 prior ( p < 0.039) in NHx patients. Following IVMP, CE lesions decreased ( p < 0.0004) for months 1, 2, and 3 in both groups, but there was no effect on WMLL. Conclusions: BFV and CE lesions were significantly decreased for 1 month (BFV) and 3 months (CE lesions) following IVMP. Therefore, MRI studies should be delayed by probably at least 2 months following IVMP to avoid a possible confounding steroid effect in a clinical trial.