Methylprednisolone therapy in 63 Iraqi patients with multiple sclerosis: a profile of side effects

ABSTRACT

To detect the nature and frequency of short and long term side effects of Methylprednisolone pulse therapy in patients with multiple sclerosis. sixty three patients with multiple sclerosis treated in multiple sclerosis clinic in Baghdad teaching hospital from April 2001 till December 2002 with one gram methylprednisolone [MPN] succinate pulse therapy were studied for short term side effects; forty six patients who received more than six doses were studied for short and long term side effects including serum lipid profile, ophthalmological complications, vascular necrosis of head of femur and osteoporosis by Achilles express device. body weight studied cross sectional at the start and after six months showed no significant changes; short term symptoms that occurred during and after pulse therapy were transient and occurred infrequently apart from taste changes in form of bitter sensation in 420 [60.87%] out of 690 pulses. There was no anaphylactic reactions, no cardiac dysrrhythmias and no deep venous thrombosis nor serious infections or septicemic complications during follow up. Blood pressure changes were not significant. Hematological investigation including hemoglobin, white blood cell count, platelets count changed within normal values after one week of pulse therapy. None of the patients developed diabetes mellitus at the end of the study. Among the 46 patients studied for long term side effects, one developed post subcapsular cataract non developed glaucoma, two showed increment in serum triglyceride, and one developed a vascular necrosis of the neck or the femur. Eighteen women receiving more than six pulses were evaluated for osteoporosis by Achellis express at the end of the study. Of them, 7 [38.88%] showed osteoporosis, 7 [38.88%] osteopenia, and 4 [22.22%] normal readings. methylprednisolone, when used on our therapeutic protocol, was a safe drug; there was a risk of developing osteoporosis for patients receiving more than 6 pulses