A Commentary on Steroid Treatment in Multiple Sclerosis

To the Editor. —A number of studies have shown that pulsed therapy with high-dose intravenously administered methylprednisolone is usually effective during multiple sclerosis (MS) relapses. It has been hypothesized that a regimen of repeated pulses of intravenous methylprednisolone, not restricted to relapses but given at regular intervals during the years of disease activity, might be effective in preventing progression of the disease. It can, however, reliably be predicted that under these circumstances the frequency of adverse effects will rise and, therefore, the importance of assessing the exact benefits and risks of such a regimen has been stressed in a number of leading articles. 1-3 We recently performed a small, open, pilot study in which monthly pulses of methylprednisolone (500 mg intravenously) were given to patients with progressive MS. Ten patients with definite MS according to the Poser criteria were selected for the study. During the 12 months before entry into