Treatments for MS: Steroids
Corticosteroids (steroids) are the standard treatment for a
relapse in
MS and have been in use for about 50 years.
How steroids work
It is still unclear exactly how steroids work but they probably act by partly suppressing the
immune system and / or by reducing fluid accumulation around the site of
nerve damage. Many studies have shown that steroids are effective in speeding up recovery from relapse but make no difference either to the degree of recovery or to the long-term progression of the condition.
How are steroids given?
Treatment may be in hospital or at home and the drug given
orally or
intravenously. It has been shown that combining steroid therapy with planned multidisciplinary team care is superior to administering drug therapy alone. The NICE Guideline states that individuals should be offered a course of high dose steroids to be started as soon as possible after the onset of the relapse. This should be either:
- IV (intravenous) methylprednisolone 500mg-1g daily for 3-5 days or
- high dose oral methylprednisolone 500mg-2g daily for 3-5 days.
Side effects and contraindications
In the short-term, the side effects of steroids are usually minor and transient. Long-term treatment should normally be avoided due to side effects including, weight gain, acne, cataracts, osteoporosis (thinning of the bones), deterioration of the head of the thigh bone and
diabetes. The NICE Guideline recommends that courses of steroids be limited to a maximum of three times a year.
