Autoimmune Disorders Expert Forum
Medrol dose pack for mild flare-ups
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Welcome to the Autoimmune Disorders forum. Questions in this forum are being answered by Dr. Garth Nicolson. This forum is for questions and discussions relating to Autoimmune Disorders. Topics include, but are not limited to: Alzheimer’s, Amyotrophic Lateral Sclerosis (ALS), Chronic Fatigue Syndrome, Fibromyalgia, Gulf War Syndrome, Lupus, Lyme Disease, MS, Rheumatoid Arthritis

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Medrol dose pack for mild flare-ups

I read about a research study done in Copenhagen last year (by Mads Ravnborg, M.D.) to test whether a monthly Medrol dose pack, added to regular interferon, would slow the progression of MS.  The study showed that the combination might reduce disease activity better than interferon alone.  Another Danish study showed a 62% reduction in relapse rates, and while lesions in the placebo group continued to grow, lesions in the treated patients either stayed the same or shrank. However, there was a high dropout rate due to steroid side effects, and it was a small sample size, so the results aren't proven yet.  

Here's my question: Have you ever heard of a neurologist using this approach?  And is there any long-term health risk from doing this, if I ask my neurologist about trying it?  I know about the serious side effects of steroids while you're using them, but do they cause any lasting, permanent health risk that would outweigh the benefit of helping manage MS symptoms?  I was officially diagnosed with MS about a year ago, after having puzzling symptoms for nearly 9 years (nocturnal seizures, which baffled my neurologist because MRIs were non-specific with no lesions).  I had my first "typical" flare-up about a year ago--vertigo that didn't go away--and the MRI then showed four lesions, so my neurologist sent me for Solu-Medrol infusions. Since then I've been on Betaseron and everything's pretty much stayed the same.  But for the last two weeks, the vertigo has come back and I've noticed a few speech and bladder control issues.  Would a Medrol dose pack help what seems to be a mild flare-up?  I'm not familiar enough with flare-ups to know when I'm having a mild one or if these are just symptoms of regular MS progression.  Would a dose pack be worth a try, to see if the symptoms go away?  I know this is more than one question, sorry!  I just wanted to know your thoughts about using a Medrol dose pack for occasional management of symptoms.  Thanks for your reply.
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This is an elaboration of methylprednisolone or steroid suppression of immune function to control autoimmunity.  It is used to manage autoimmune disorders without getting at the cause.  You should discuss this option with your neurologist.  When patients have other systemic signs and symptoms we usually suggest that other things might be going on, such as chronic infections (also found in most MS patients).  I have reviewed this topic recently in the British Journal of Medical Practitioners, an open access journal.  It is the last issue of 2009, if you are interested.
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