Methylprednisolone for the treatment of Immune-mediates Diseases flares. Relationship between doses, effectiveness and safety. A pilot study.

Abstract

Background: Methylprednisolone (MTP) pulses have proved effectiveness for the treatment of severe manifestations of immune-mediated diseases (ID). However, the the relationship between doses, effectiveness and safety is not well established.

Objective: To know MTP indications, doses, therapeutic response and safety in the clinical setting.

Methodology: A retrospective review of records was performed in Hospital Pasteur of Uruguay, from patients who had received MTP during a ID flare.  Variables studied: age, sex, MTP cumulative doses, duration of treatment, therapeutic response and adverse effects.

Results: Thirty six cases were identified, 26 were female. The mean age was 41,5 (SD 15,5) years. The mean dose of MTP in cases of complete response was 3,6 (SD 2) grams, the mean dose in cases of partial response was 4 (SD 1,5) grams, and in cases of no response was 2,8 (SD 1,2) grams (p> 0,05). The mean dose in patients with adverse effects was 4,4 (SD 1,8) grams, and in cases without adverse effects was 3,2 (SD 1,6) grams (p<0,05).

Conclusions: Our series does not confirm a relationship between higher doses and clinical response. However, an association between higher doses of MTP and adverse effects was observed. These finding should be thoroughly investigated.