DOI: https://doi.org/10.22141/2224-0713.7.101.2018.149659

Comparative efficacy of hormone pulse therapy in relapsing and secondary progressive multiple sclerosis with different prognosis

N.P. Voloshyna, T.V. Negreba, V.V. Vasylovsky, K.O. Pisotska, T.N. Tkacheva, M.Ye. Chernen

Abstract


We have investigated the efficiency of pulse glucocorticoid (GCT) therapy in 70 patients at the stage of progression in secondary progressive course (SPC) of multiple sclerosis with uncertain prognosis (30 individuals, 21 women and 9 men) and with unfavorable prognosis (40 individuals, 36 women and 4 men). Analyzing the effectiveness of treatment, we have considered the following clinical indicators: the duration of progression stage by the time of the study; types and rates of progression; the degrees of disability according the Expanded Disability Status Score (EDSS). The effectiveness of treatment at the stage of progression in SPC in patients with different nature of prognosis has been evaluated taking into account the following criteria: the duration of the progression stage by the time of the last GCT therapy; the types of progression (steady, recurrent and progressive); the comparative evaluation of remissions’ duration (at the recurring stage with a future SPC) and/or stabilization (at the stage of progression) after the first and before the last GCT therapy; the scores according the EDSS after the first and before the last GCT therapy; the rates of progression. The results of treatment in patients with uncertain prognosis of SPC showed a moderate effect (21 individuals) leading to a more favorable progressive type, and low efficacy (9 individuals) with less favorable — the recurrent course of progression. GCT therapy was found to be far less effective (low efficiency — in 12 patients, lack of efficacy — in 28 patients) in persons with unfavorable prognosis of SPC, who were characteri-
zed by the least favorable steady type of progression (21 individuals), recurrent type of progression (17 individuals) and by rotation of steady and recurrent (2 individuals) types of progression. Thus, the studies, that we have conducted, showed that the effectiveness of glucocorticoid therapy in the secondary progressive course of multiple sclerosis depends on the type of prognosis. It was determined by the complex interaction of clinical indicators having the prognostic significance, as well as by the number of genetic factors that require the further observation.


Keywords


multiple sclerosis; course; prognosis; pulse glucocorticoid therapy; treatment effectiveness

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