Satisfaction, Safety and Cost of the Treatment for Multiple Sclerosis Relapse with Intravenous versus Oral Methylprednisolone

Abstract

Introduction: Relapse is a clinical indication of MS activity. Treatment with corticosteroids is recommended for anti-inflammatory, immunosuppressive effects and reduction in the duration and intensity of symptoms. The dosage of intravenous methylprednisolone (ivMP) is 500-1000 mg daily and that of oral methylprednisolone (oMP) is 500-1250 mg daily for 3-5 days. There are no differences in the immune, clinical and radiological response between the two administration routes. Tolerance is good. The main objective of this study is to determine the degree of satisfaction of treatment with oMP versus ivMP. The secondary objectives are: to evaluate clinical recovery, side effects and costs. Materials and Methods: 52 Patients received both oMP and ivMP as treatment for MS relapse in the period 2010-2014. All the patients answered a questionnaire. The cost analysis was performed with the HUC costing schedule. Results: 58% of the MS patients said that oral administration was the most comfortable way to treat a relapse. The side effects were similar. Patients positively valued not having to go to hospital (92%), or going to the hospital day-case unit (86%). The overall satisfaction score was 6.7 (max 10) for oMP and 6.5 for ivMP The severity and recovery times for the relapse were similar (56%). The cost of a relapse treated with oMP was €166.23, €575.5 for ivMP and the costs of the day-case unit services were €1130. Conclusions: oMP can be considered as a satisfactory, comfortable and safe alternative in the treatment of an MS relapse. There is a notable monetary saving.

Keywords

• Intravenous methylprednisolone
• Multiple sclerosis relapse
• Oral methylprednisolone
• Satisfaction
• Treatment Costs