Table 8.
Intravenous methylprednisolone versus oral methylprednisolone
| Study/N/Age/Location | Intervention and treatment duration | Summary of efficacy results |
|---|---|---|
| Alam et al (1993)38 N=35 Mean age, years: injection, 41.6; tablets, 41.3 UK |
Intervention IVMP (n=20) vs OMP (n=15) Treatment duration IVMP and OMP: 5 days Assessments Days 0, 5, and 28 |
DSS mean score Baseline: IVMP, 4.85; OMP, 4.80 Day 5: Results not presented. Day 28: IVMP, 3.5; OMP, 3.67 P<0.01 for both groups vs baseline |
| Barnes et al (1997);37 N=80 Mean age, years (SD): IVMP, 37 (11.1); OMP, 38 (9.6) UK |
Intervention IVMP (n=38) vs OMP (n=42) Treatment duration IVMP, 3 days; OMP, 21 days Assessments Baseline, 1 week, 4 weeks, 12 weeks, and 24 weeks |
EDSS median (IQR) Baseline: IVMP, 6.0 (3.5–7.5); OMP: 5.0 (3.5–6.5) Change (improvement) from baseline at: Week 1: IVMP, 0 (0–0.5); OMP, 0.5 (0–1) Week 4: IVMP, 0.5; OMP, 0.5 (adjusted mean difference, −0.017; P=0.80) Week 12: IVMP, 0.5 (0–1.5); OMP, 0.5 (0–1.5) Week 24: IVMP, 0.5 (0–1.5); OMP, 0.75 (0–1.5) |
| COPOUSEP Trial (2015)36 N=199 Median age, years: oral: 35.0; IV: 34.7 France |
Intervention IVMP (n=99) vs OMP (n=100) Treatment duration 3 days Assessments 1 week, 4 weeks, and 12 weeks |
Mean EDSS score improvement from baseline (1 week) 4 weeks: OMP, 1.5; IVMP, 1.3 (difference, 0.13; P=0.57) 12 weeks: OMP, 1.6; IVMP, 1.5 (difference, 0.1; P=0.69) |
| Martinelli et al (2009)35 N=40 Mean age, years: IVMP: 31.0 (7.0); OMP: 36.0 (8.0) Italy |
Intervention IVMP (n=20) vs OMP (n=20) Treatment duration 5 days Assessments Baseline, weeks 1 and 4 |
Improvement (≥1 point in EDSS score); P<0.001 for both groups: Week 1: IVMP, 65%; OMP, 35% Week 4: IVMP, 85%; OMP, 55% EDSS did not differ between the 2 groups at the different time points |
| Ramo-Tello et al (2014);34 Grau-Lopez et al (2014)39 N=49 Mean age, years: IVMP, 37.7; OMP, 39.5 Spain |
Intervention IVMP (n=24) vs OMP (n=25) Treatment duration 3 days Assessments Baseline and weeks 1, 4, and 12 |
Improvement in EDSS scores (≥1 score change) vs baseline at 4 weeks: IVMP, 1.11; OMP, 1.11 (mean difference between groups, 0.00; P=0.988) |
Abbreviations: COPOUSEP, Corticothérapie Orale dans les Poussées de Sclérose en Plaques; DSS, Disability Status Scale; EDSS, Expanded Disability Status Scale; IQR, interquartile range; IV, intravenous; IVMP, intravenous methylprednisolone; NR, not reported; OMP, oral methylprednisolone; SD, standard deviation; UK, United Kingdom.