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Latest & greatest articles for methylprednisolone
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Intravenous immunoglobulin or high-dose methylprednisolone, with or without oral prednisone, for adults with untreated severe autoimmune thrombocytopenic purpura: a randomised, multicentre trial. Treatment of adults with autoimmune thrombocytopenic purpura (AITP) is based more on individual experience than on results of controlled studies. We compared intravenous immunoglobulin with high-dose methylprednisolone in untreated adults with severe AITP and assessed efficacy of subsequent oral (...) steroids compared with placebo. Primary outcome was number of days with platelet count greater than 50 x 10(9)/L within the first 21 days.We did a randomised multicentre trial based on a 232 design. 122 adults with severe AITP (platelet count < or =20 x 10(9)/L) were randomly assigned to receive either intravenous immunoglobulin or high-dose methylprednisolone on days 1-3 (randomisation A), and then to receive either oral prednisone or placebo (randomisation B) on days 4-21. Analysis was by intention
2002LancetControlled trial quality: predicted high
Cyclophosphamide versus methylprednisolone for the treatment of neuropsychiatric involvement in systemic lupus erythematosus. Neuropsychiatric involvement in systemic lupus erythematosus is complex and several clinical presentations are related to this disease such as: convulsions, chronic headache, transverse myelitis, vascular brain disease, psychosis and neural cognitive dysfunction.To assess the efficacy and safety of cyclophosphamide and methylprednisolone in the treatment (...) of neuropsychiatric manifestations of systemic lupus erythematosus on mortality and side effects.We searched EMBASE, LILACS, Cochrane Controlled Trials Register and MEDLINE up to and including December 1999, additional articles were sought through handsearching in relevant journals, using the search strategy described in the Cochrane Handbook [Dickersin 1994]. There were no language restrictions.All randomized controlled trials which compared cyclophosphamide to methylprednisolone were to be included. Patients
Intrathecal methylprednisolone for intractable postherpetic neuralgia. There is no effective treatment for intractable postherpetic neuralgia. Because there is evidence that postherpetic neuralgia has an inflammatory component, we assessed treatment with intrathecally administered methylprednisolone to reduce pain in patients with this disorder.We enrolled 277 patients who had had intractable postherpetic neuralgia for at least one year, 270 of whom were followed for two years. The patients (...) were randomly assigned to receive intrathecal methylprednisolone and lidocaine (3 ml of 3 percent lidocaine with 60 mg of methylprednisolone acetate, 89 patients), lidocaine alone (3 ml of 3 percent lidocaine, 91 patients), or no treatment (90 patients) once per week for up to four weeks. Each weekly dose was injected into the lumbar intrathecal space. Pain was evaluated before randomization, at the end of the treatment period, and then four weeks, one year, and two years later. Samples
High dose methylprednisolone in the management of acute spinal cord injury: a systematic review from a clinical perspective High dose methylprednisolone in the management of acute spinal cord injury: a systematic review from a clinical perspective High dose methylprednisolone in the management of acute spinal cord injury: a systematic review from a clinical perspective Short D J, El Masry W S, Jones P W Authors' objectives To evaluate the evidence for an effect of high-dose methylprednisolone (...) (MPSS) on neurological improvement, following acute spinal cord injury (ASCI). Searching MEDLINE was searched from 1966 through December 1999 using the terms 'spinal cord injury' and 'methylprednisolone', or 'spinal cord injury' and 'dexamethasone', with no other restrictions. Additional relevant studies were located by examining the references of a review for pharmacological treatment of ASCI on the Cochrane Database of Systematic Reviews, and by manually checking the reference lists
Risks and benefits of preoperative high dose methylprednisolone in surgical patients: a systematic review Risks and benefits of preoperative high dose methylprednisolone in surgical patients: a systematic review Risks and benefits of preoperative high dose methylprednisolone in surgical patients: a systematic review Sauerland S, Nagelschmidt M, Mallmann P, Neugebauer E A Authors' objectives To conduct a risk-benefit analysis using a meta-analysis, for the comparison of complication rates (...) and clinical advantages associated with the use of high-dose methylprednisolone in surgical patients. Searching PubMed and the Cochrane Library (Issue 2, 2000) were searched using the term 'methylprednisolone' and the publication type 'randomised controlled trial'. Both searches were repeated in August 2000. The references of all articles and two related Cochrane reviews were checked for further studies. The manufacturer of a commonly-used MPSS was also contacted for further information. Study selection
A meta-analysis of methylprednisolone in recovery from multiple sclerosis exacerbations A meta-analysis of methylprednisolone in recovery from multiple sclerosis exacerbations A meta-analysis of methylprednisolone in recovery from multiple sclerosis exacerbations Miller D M, Weinstock-Guttman B, Bethoux F, Lee J C, Beck G, Block V, Durelli L, LaMantia L, Barnes D, Sellebjerg F, Rudick R A Authors' objectives To assess methylprednisolone (MP) at different doses, and in comparison with other (...) steroid products, in the treatment of multiple sclerosis exacerbations. Searching MEDLINE was searched from 1981 to 1998, and EMBASE from 1980 to 1998, combining 'Multiple Sclerosis' (as an index term) with 'Methylprednisolone' (either as an index term or in 'authors, title or abstract'). The references of identified articles and recent review articles were also examined. No restrictions on publication language were specified. Study selection Study designs of evaluations included in the review
Injection with methylprednisolone proximal to the carpal tunnel: randomised double blind trial. To assess the effect of a 40 mg methylprednisolone injection proximal to the carpal tunnel in patients with the carpal tunnel syndrome.Randomised double blind placebo controlled trial.Outpatient neurology clinic in a district general hospital.Patients with symptoms of the carpal tunnel syndrome for more than 3 months, confirmed by electrophysiological tests and aged over 18 years.Injection with 10 mg (...) lignocaine (lidocaine) or 10 mg lignocaine and 40 mg methylprednisolone. Non-responders who had received lignocaine received 40 mg methylprednisolone and 10 mg lignocaine and were followed in an open study.Participants were scored as having improved or not improved. Improved was defined as no symptoms or minor symptoms requiring no further treatment.At 1 month 6 (20%) of 30 patients in the control group had improved compared with 23 (77%) of 30 patients the intervention group (difference 57% (95
Effect of prolonged methylprednisolone therapy in unresolving acute respiratory distress syndrome: a randomized controlled trial. No pharmacological therapeutic protocol has been found effective in modifying the clinical course of acute respiratory distress syndrome (ARDS) and mortality remains greater than 50%.To determine the effects of prolonged methylprednisolone therapy on lung function and mortality in patients with unresolving ARDS.Randomized, double-blind, placebo-controlled (...) trial.Medical intensive care units of 4 medical centers.Twenty-four patients with severe ARDS who had failed to improve lung injury score (LIS) by the seventh day of respiratory failure.Sixteen patients received methylprednisolone and 8 received placebo. Methylprednisolone dose was initially 2 mg/kg per day and the duration of treatment was 32 days. Four patients whose LIS failed to improve by at least 1 point after 10 days of treatment were blindly crossed over to the alternative treatment.Primary outcome
Effect of prolonged methylprednisolone therapy in unresolving acute respiratory distress syndrome: a randomized controlled trial PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Randomised trial of oral and intravenous methylprednisolone in acute relapses of multiple sclerosis. An intravenous rather than oral course of methylprednisolone is often prescribed for treating acute relapses in multiple sclerosis (MS) despite the lack of evidence to support this route of administration. Our double-blind placebo-controlled randomised trial was designed to compare the efficacy of commonly used intravenous and oral steroid regimens in promoting recovery from acute relapses in MS (...) .42 patients with clinically definite relapse in MS received oral, and 38 intravenous, methylprednisolone. Clinical measurements at entry and at 1 week, 4 weeks, 12 weeks, and 24 weeks included Kurtzke's expanded disability status scale (EDSS), Hauser's Ambulatory Index, and an arm-function index. The primary outcome criterion was a difference between the two treatment groups of one or more EDSS grades at 4 weeks.There were no significant differences between the two groups at any stage
1997LancetControlled trial quality: predicted high
Administration of methylprednisolone for 24 or 48 hours or tirilazad mesylate for 48 hours in the treatment of acute spinal cord injury. Results of the Third National Acute Spinal Cord Injury Randomized Controlled Trial. National Acute Spinal Cord Injury To compare the efficacy of methylprednisolone administered for 24 hours with methyprednisolone administered for 48 hours or tirilazad mesylate administered for 48 hours in patients with acute spinal cord injury.Double-blind, randomized clinical (...) trial.Sixteen acute spinal cord injury centers in North America.A total of 499 patients with acute spinal cord injury diagnosed in National Acute Spinal Cord Injury Study (NASCIS) centers within 8 hours of injury.All patients received an intravenous bolus of methylprednisolone (30 mg/kg) before randomization. Patients in the 24-hour regimen group (n=166) received a methylprednisolone infusion of 5.4 mg/kg per hour for 24 hours, those in the 48-hour regimen group (n=167) received a methylprednisolone
High-dose intravenous methylprednisolone therapy for pain in children and adolescents with sickle cell disease. The management of episodes of severe pain in patients with sickle cell disease is a difficult clinical problem. We studied 36 children and adolescents with sickle cell disease who had 56 acute episodes of severe pain (44 in 27 patients with sickle cell anemia, 8 in 7 patients with sickle cell-hemoglobin C disease, and 4 in 2 patients with sickle cell-beta (+)-thalassemia (...) ). The patients were randomly assigned in double-blind fashion to receive an intravenous infusion of either saline placebo or high-dose methylprednisolone (15 mg per kilogram of body weight, to a maximum of 1000 mg) on their admission to the hospital and again 24 hours later. All the patients received intravenous morphine sulfate until severe pain abated and were then given acetaminophen with codeine.For all episodes of pain, the duration of inpatient analgesic therapy (intravenous and oral) was significantly
Controlled trial of pulse methylprednisolone versus two regimens of pulse cyclophosphamide in severe lupus nephritis. Pulse cyclophosphamide is more effective than prednisone alone in preventing renal failure in lupus nephritis. We undertook a randomised, controlled trial to find out whether pulse methylprednisolone could equal pulse cyclophosphamide in preserving renal function in patients with lupus nephritis, and whether there was a difference between long and short courses of pulse (...) cyclophosphamide in preventing exacerbations. 65 patients (60 female, 5 male; median [range] age 29 [10-48] years) with severe lupus nephritis were assigned randomly to monthly pulse methylprednisolone for 6 months (25 patients), monthly pulse cyclophosphamide for 6 months (20), or monthly cyclophosphamide for 6 months followed by quarterly pulse cyclophosphamide for 2 additional years (20). Patients treated with pulse methylprednisolone had a higher probability of doubling serum creatinine than those treated
Methylprednisolone plus chlorambucil as compared with methylprednisolone alone for the treatment of idiopathic membranous nephropathy. The Italian Idiopathic Membranous Nephropathy Treatment Study Group. Treatment with methylprednisolone and chlorambucil may protect renal function and increase the chance of remission of the nephrotic syndrome in patients with idiopathic membranous nephropathy. To determine whether similar results might be obtained with methylprednisolone alone, we compared (...) the effects of methylprednisolone and chlorambucil with those of methylprednisolone alone in 92 patients with the nephrotic syndrome caused by idiopathic membranous nephropathy. The patients were randomly assigned to receive either alternating one-month courses of methylprednisolone and then chlorambucil for a total of six months (group 1) or methylprednisolone alone for six months at the same cumulative dosage (group 2).Four of the 45 patients in group 1 (9 percent) and 1 of the 47 in group 2 (2 percent
Randomized, double-blind cross-over study of acute cisplatin-induced nausea and vomiting, comparing a new schedule of the combination of metoclopramide and methylprednisolone versus metoclopramide alone. 2261379 1991 02 07 2016 10 17 0923-7534 1 5 1990 Sep Annals of oncology : official journal of the European Society for Medical Oncology Ann. Oncol. Randomized, double-blind cross-over study of acute cisplatin-induced nausea and vomiting, comparing a new schedule of the combination (...) of metoclopramide and methylprednisolone versus metoclopramide alone. 379-80 Díaz-Rubio E E Servicio de Oncología Médica, Hospital Universitario San Carlos, Madrid. González-Larriba J L JL Rosell R R Abad A A Martín M M Valerdi J J JJ Barriga J J JJ eng Clinical Trial Comparative Study Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't England Ann Oncol 9007735 0923-7534 L4YEB44I46 Metoclopramide Q20Q21Q62J Cisplatin X4W7ZR7023 Methylprednisolone IM Adult Aged Cisplatin adverse effects
Treatment of aplastic anemia with antilymphocyte globulin and methylprednisolone with or without cyclosporine. The German Aplastic Anemia Study Group. Immunosuppression is the most effective treatment for patients with aplastic anemia, except for bone marrow transplantation. The best results are achieved with antilymphocyte globulin or cyclosporine. Patients have been treated successfully with a combination of both agents, but there has been no controlled evaluation of its efficacy. We (...) conducted a randomized, multicenter trial in 84 patients not eligible for bone marrow transplantation, comparing treatment with antilymphocyte globulin and methylprednisolone (41 patients--the control group) with antilymphocyte globulin, methylprednisolone, and cyclosporine (43 patients--the cyclosporine group).At three months significantly more patients in the cyclosporine group had a complete or partial remission in response to treatment than did patients in the control group (65 percent vs. 39
A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal-cord injury. Results of the Second National Acute Spinal Cord Injury Study. Studies in animals indicate that methylprednisolone and naloxone are both potentially beneficial in acute spinal-cord injury, but whether any treatment is clinically effective remains uncertain. We evaluated the efficacy and safety of methylprednisolone and naloxone in a multicenter randomized, double-blind, placebo (...) -controlled trial in patients with acute spinal-cord injury, 95 percent of whom were treated within 14 hours of injury. Methylprednisolone was given to 162 patients as a bolus of 30 mg per kilogram of body weight, followed by infusion at 5.4 mg per kilogram per hour for 23 hours. Naloxone was given to 154 patients as a bolus of 5.4 mg per kilogram, followed by infusion at 4.0 mg per kilogram per hour for 23 hours. Placebos were given to 171 patients by bolus and infusion. Motor and sensory functions were
Double blind placebo controlled trial of pulse treatment with methylprednisolone combined with disease modifying drugs in rheumatoid arthritis. To assess whether monthly treatment with intravenous methylprednisolone enhances or accelerates the effect of disease modifying drugs in patients with rheumatoid arthritis.A 12 month double blind, placebo controlled, multicentre trial in which patients with active rheumatoid arthritis were randomly allocated to receive pulses of either (...) methylprednisolone or saline every four weeks for six months. At the start of the pulse treatment all patients were started on penicillamine or azathioprine.Four rheumatology departments in Denmark.97 Patients (71 women, 26 men) aged 23-84 (mean 60) who had active rheumatoid arthritis of at least four weeks' duration despite treatment with non-steroidal anti-inflammatory drugs.Monthly clinical recording of morning stiffness, number of tender and swollen joints, blinded observers' evaluation of therapeutic effect
A randomized trial of methylprednisolone and chlorambucil in idiopathic membranous nephropathy. We conducted a controlled trial to investigate the long-term effects of treatment with methylprednisolone and chlorambucil in patients with idiopathic membranous nephropathy. We have previously reported that after a mean of 31 months, treated patients did better. We now report the results of a longer follow-up. Eighty-one patients with proteinuria (greater than or equal to 3.5 g per day) and biopsy (...) -proved membranous nephropathy were randomly assigned to receive either supportive therapy alone or a six-month course of corticosteroids alternated with chlorambucil (0.2 mg per kilogram of body weight per day) every other month. Methylprednisolone was first given intravenously in three pulses (1 g per day) and was then given orally (0.4 mg per kilogram per day) for 27 days. The patients were followed for 2 to 11 years (median, 5). Two patients in the control group and one in the treatment group died