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Low-dose corticosteroids reduce relapses in neuromyelitis optica: a retrospective analysis

Department of Neurology, Tohoku University School of Medicine, Sendai, Japan

T. Misu

Department of Neurology, Tohoku University School of Medicine, Sendai, Japan

I. Miyazawa

Department of Neurology, Tohoku University School of Medicine, Sendai, Japan

I. Nakashima

Department of Neurology, Tohoku University School of Medicine, Sendai, Japan

Y. Shiga

Department of Neurology, Tohoku University School of Medicine, Sendai, Japan

K. Fujihara

Department of Neurology, Tohoku University School of Medicine, Sendai, Japan

Y. Itoyama

Department of Neurology, Tohoku University School of Medicine, Sendai, Japan

Neuromyelitis optica (NMO) is a relapsing neurologic disease characterized by severe optic neuritis and transverse myelitis. A disease-modifying therapy for NMO has not been established. We retrospectively analysed the effect of low-dose corticosteroid (CS) monotherapy on the annual relapse rate in nine patients with NMO. We divided the clinical course in each patient into two periods; the CS Period in which CS was administered, and the No CS Period in which CS was not administered. Periods related to other immunological therapies, such as high-dose methylprednisolone, immunosuppressants, interferon-beta, and plasma exchange, were excluded. As a result, the annual relapse rate during the CS Periods [median, 0.49 (range, 0—1.31)] was found to be significantly lower than that during the No CS Periods [1.48 (0.65—5.54)]. As for the dose of CS, relapses occurred significantly more frequently with `10 mg/day or less' than with `over 10 mg/day' (odds ratio: 8.75). The results of the present study suggest a beneficial effect of low-dose CS monotherapy in reducing relapses in NMO. Multiple Sclerosis 2007; 13: 968—974. http://msj.sagepub.com

Key Words: autoantibody • corticosteroids • Devic's disease • neuromyelitis optica • relapse • therapy

This version was published on September 1, 2007

Multiple Sclerosis, Vol. 13, No. 8, 968-974 (2007)
DOI: 10.1177/1352458507077189


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