Alam, 19931414 Alam SM, Kyriakides T, Lawden M, Newman PK. Methylprednisolone in multiple sclerosis: a comparison of oral with intravenous therapy at equivalent high dose. J Neurol Neurosurg Psychiatry. 1993;56(11):1219-20. DOI: 10.1136/jnnp.56.11.1219 https://doi.org/10.1136/jnnp.56.11.1219...
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OMP group: 500mg/d of oral MP as five 100mg tablets with 100mL of placebo intravenously for 5 days IVMP group: 500mg/d of intravenous MP in 100mL of saline solution with five placebo tablets for 5 days |
1.Proportion of patients with improvement on EDSS at day 28 2.Proportion of patients with improvement on EDSS at day 5 3.Adverse event rates |
Barnes 19971515 Barnes D, Hughes RA, Morris RW, Wade-Jones O, Brown P, Britton T, et al. Randomised trial of oral and intravenous methylprednisolone in acute relapses of multiple sclerosis. Lancet 1997;349(9056):902-6. DOI: 10.1016/S0140-6736(96)06453-7 https://doi.org/10.1016/S0140-6736(96)06...
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OMP group: 48 mg/d x 7 days,then 24 mg/d x 7 days,finally 12mg/d x 7 days IVMP group: 1000mg/d of intravenous MP in 100 mL of a 5% dextrose solution for 3 days |
1.Proportion of patients with improvement on EDSS at 4 weeks 2.Median EDSS at 0-1 weeks,0-4 weeks,0-12 weeks,0-24 weeks and over all area under the curve 3.Median ambulatory index at 0-1 weeks,0-4 weeks,0-12 weeks,0-24 weeks and over all area under the curve 4.Median arm index at 0-1 weeks,0-4 weeks,0-12 weeks,0-24 weeks and over all area under the curve 5.Proportion discharged from hospital at week 1 and week 4 6.Adverse event rates |
Morrow 20041616 Morrow SA, Stoian CA, Dmitrovic J, Chan SC, Metz LM. The bioavailability of IV methylprednisolone and oral prednisone in multiple sclerosis. Neurology. 2004;63(6):1079-80.
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OMP group: 1250mg of oral prednisone IVMP group: 1000mg/d of intravenous MP in 100 mL of 0.9% sodium chloride |
1.Mean absorption of steroid absorption by liquid chromatography/mass spectrometry at 1, 2, 4, 8, 24 and 48 hours following treatment 2.Mean area under the curve for absorption by liquid chromatography/mass spectrometry at 1, 2, 4, 8, 24 and 48 hours following treatment |
Martinelli 20081717 Martinelli V, Rocca MA, Annovazzi P, Pulizzi A, Rodegher M, Martinelli Boneschi F, et al. A short-term randomized MRI study of high-dose oral vs intravenous methylprednisolone in MS. Neurology. 2009;73(22):1842-8. DOI: 10.1212/WNL.0b013e3181c3fd5b. https://doi.org/10.1212/WNL.0b013e3181c3...
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OMP group: 500mg of oral MP × 2/day for 5 days IVMP group: 1000mg/d of intravenous MP for 5 days |
1.Number of gadolinium-enhancing lesions on MRI 1 week after steroid treatment 2.Number of gadolinium-enhancing lesions on MRI 4 weeks after steroid treatment 3.Proportion of patients with improvement on EDSS at 1 week 4.Proportion of patients with improvement on EDSS at 4 weeks 5.Adverse event rates |
Remo-Tello 20141818 Ramo-Tello C, Grau-Lopez L, Tintore M, Rovira A, Ramió i Torrenta L, et al. A randomized clinical trial of oral versus intravenous methylprednisolone for relapse of MS. Mult scler. 2014;20(6):717-25. DOI: 10.1177/1352458513508835. https://doi.org/10.1177/1352458513508835...
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OMP group: 1250mg of oral MP 3 days+intravenous placebo IVMP group: 1000mg/d of intravenous MP for 3 days+oral placebo |
1.Proportion of patients with improvement on EDSS of at least one poin at 1 week,4 weeks and 12 weeks 2.Number and volume of new and persistent T1 gadolinium-enhancing lesions on MRI at 1 week and 4 weeks 3.Number and volume of new and persistent? T2 lesions on MRI at 1 week and 4 weeks 4.Adverse event rates |
Le Page 20151212 Le Page E, Veillard D, Laplaud DA, Hamonic S, Wardi R, Lebrun C, et al. Oral versus intravenous high-dose methylprednisolone for treatment of relapses in patients with multiple sclerosis (COPOUSEP): a randomised, controlled, double-blind, non-inferiority trial. Lancetet al. Oral versus intravenous high-dose methylprednisolone for treatment of relapses in patients with multiple sclerosis (COPOUSEP): a randomised, controlled, double-blind, non-inferiority trial. Lancet. 2015;386(9997):974-81. DOI: 10.1016/S0140-6736(15)61137-0. https://doi.org/10.1016/S0140-6736(15)61...
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OMP group: 1000mg of oral MP for 3 days IVMP group: 1000mg/d of intravenous MP for 3 days |
1.the proportion of patients who decrease of at least one point in most affected score on EDSS by day 28 2.the proportion of patients who decrease of at least one point in most affected score on EDSS by day 180 3.Adverse event rates |