Re-examining the effects of high-dose intravenous methylprednisolone for secondary progressive multiple sclerosis.

Intravenous methylprednisolone (IVMP) is previously given to secondary progressive multiple sclerosis (SPMS) patients. This study aimed to re-examine the effects of IVMP in SPMS. Major electronic databases were searched for randomized controlled trials. Four randomized controlled trials were included. IVMP may be inferior to mitoxantrone (MTX) in terms of expanded disability status scale (EDSS) improvement. There was no significant difference in terms of EDSS reduction and magnetic resonance imaging (MRI) plaque reduction when IVMP + MTX were compared with MTX. There is no significant difference between IVMP and cyclophosphamide based on EDSS progression and relapse reduction. IVMP should not be routinely used as treatment for SPMS and is not recommended as an alternative treatment for SPMS.