Treatment of Exacerbations of Multiple Sclerosis without the Use of Corticosteroids: The Role of Metabolic and Antioxidant Therapy

A multicenter randomized post-registration case-control study was performed with 94 patients with relapsing-remitting and secondary progressive multiple sclerosis (MS) in exacerbation. The patients were divided into two groups: group 1 (n = 53) received Cytoflavin and basal therapy (Trental and group B vitamins), while group 2 (n = 41) received only basal therapy. After five days, treatment results were used to further divide each group into two subgroups: patients of subgroup 1A (n = 22), with clear positive treatment effects, continued to receive Cytoflavin and basal therapy; group 1B (n = 31) additionally received corticosteroid (methipred) pulse therapy; subgroup 2A (n = 14), with significant positive effects, continued to receive basal therapy; group 2B (n = 27) additionally received corticosteroid pulse therapy. The complex treatment, with Cytoflavin, Trental, group B vitamins, and corticosteroids, was found to be safe and well tolerated. The positive effects of including Cytoflavin in complex treatment consisted of a reduction in the need for corticosteroids: 41.5% of patients receiving Cytoflavin no longer needed them, compared with 34% of patients receiving only basal therapy. Patients given Cytoflavin showed more significant regression of neurological symptomatology on the EDSS than the group not given Cytoflavin; there were no patients with no treatment response; lipid peroxidation and anti-myelin basic protein antibody levels decreased; cognitive functions improved.