Ramo-Tello Cristina, Tintoré Mar, Rovira Alex, Ramió-Torrenta Luis, Brieva Luis, Saiz Albert, Cano Antonio, Carmona Olga, Hervás Jose V, Grau-López Laia
Hospital Germans Trias i Pujol, Badalona, Spain
Hospital Vall Hebron, Barcelona, Spain.
Mult Scler. 2016 Jan;22(1):117-21. doi: 10.1177/1352458515590648. Epub 2015 Jun 25.
To date, there are no available factors to predict the outcome after multiple sclerosis relapse.
To investigate factors that may be useful for predicting response to methylprednisolone treatment, following a relapse of multiple sclerosis (MS).
The study included 48 MS patients enrolled in a double-blind multicenter trial to receive intravenous versus oral high-dose methylprednisolone treatment. Associations were sought between the disability status prior to relapse and the relapse severity, determined by changes in the Expanded Disability Status Scale (EDSS) score, as well as the improvements after treatment. We also analyzed the relationships between the number of magnetic resonance imaging (MRI) gadolinium-enhancing lesions (Gd+) and improvement.
A higher EDSS score before relapse was associated with more severe relapses (p = 0.04) and less marked improvement (odds ratio (OR) 1.8; 95% CI (1.2-2.2); p = 0.05) after methylprednisolone treatment. Relapse severity (p = 0.29) and the number of Gd+ lesions at relapse (p = 0.41) were not related with improvement.
Clinical baseline status prior to MS relapse is a predictor of response to methylprednisolone treatment.
迄今为止，尚无可用因素来预测多发性硬化症复发后的预后。
研究在多发性硬化症（MS）复发后，可能有助于预测对甲基泼尼松龙治疗反应的因素。
该研究纳入了48名参与双盲多中心试验的MS患者，他们接受静脉注射与口服高剂量甲基泼尼松龙治疗。在复发前的残疾状态与复发严重程度之间寻求关联，复发严重程度由扩展残疾状态量表（EDSS）评分的变化确定，以及治疗后的改善情况。我们还分析了磁共振成像（MRI）钆增强病变（Gd+）数量与改善情况之间的关系。
复发前较高的EDSS评分与更严重的复发相关（p = 0.04），并且在甲基泼尼松龙治疗后改善不明显（优势比（OR）1.8；95%置信区间（1.2 - 2.2）；p = 0.05）。复发严重程度（p = 0.29）和复发时Gd+病变数量（p = 0.41）与改善情况无关。
MS复发前的临床基线状态是对甲基泼尼松龙治疗反应的一个预测指标。
