The investigators plan to carry out a multicenter randomized clinical trial and MRI study of high-dose oMP (1250mg/day for 3 days) versus lower-high dose oMP (625mg/day for 3 days) and demonstrated that lower-high dose of oMP is as effective as a higher-high dose of oMP in acute relapse of multiple sclerosis (MS). If it is shown, our purpose is to promote this therapeutic regimen because it is safer for the patient (less adverse effects) and less costly to the healthcare system.
DESIGN: Phase IV clinical trial, multicentre, randomized and double blind, active drug controlled and parallel groups. Patients will be randomised to a high dose of oMP vs a lower-high dose of oral Methylprednisolone (oMP). SETTING: 9 MS Units from 9 hospitals of the public health system with extensive experience in treating patients with MS and design and participation in clinical trials. PROCEDURES: After signing the informed consent, the inclusion and exclusion criteria specific to the study will be checked. The diagnostic test will take place prior to administration of study medication and will include medical history, neurological examination (EDSS measurement) taking of vital signs (blood pressure, heart rate and body temperature) and MRI. Concomitant medication will be checked. Patients will be instructed about the requirements during the study. The trial medication will be provided to the patient in the medical office (day 1 of the study), where the patient will remain until the intake. This action will be repeated the following 2 days. The latency period from the beginning of the relapse until the start of treatment will be registered. The questionnaires of tolerance will be completed. Day 1 will be defined as the first day on which first dose of oMP is administered. Once given the treatment under study, the adverse events reported spontaneously or after question will be collected. There will be follow-up visits at 7 and 28 days, and 3 months after initiation of treatment. At baseline, prior to drug administration, and on days 7 and 28 after initiation of treatment, a brain MRI with and without contrast will be performed. In case of adverse events or laboratory abnormalities, the patients could have an accessory follow-up visits until resolution. Randomization will be performed on the day of administration (day 1) The treatments are: Group A: Methylprednisolone 1250 mg / day orally for 3 days Group B: Methylprednisolone 625 mg / day orally for 3 days
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
49
Oral Methylprednisolone 1.250 mg daily, over 1 hour and during 3 consecutive days. 13 capsules will be administered (12 capsules of 100 mg and 1 capsule of 50 mg)
Oral Methylprednisolone 625 mg daily, over 1 hour and during 3 consecutive days. 13 capsules will be administered (6 capsules of 100 mg, 1 capsule of 25 mg and 6 capsules of placebo with the same appearance of capsules of 100 mg)
Hospital Universitari Germans Trias I Pujol de
Badalona, Barcelona, Spain
Hospital Del Mar
Barcelona, Barcelona, Spain
Hospital de Mataró
Barcelona, Barcelona, Spain
Hospital Clinic I Provincial de Barcelona
Barcelona, Barcelona, Spain
Hospital de Sant Joan Despí Moisés Broggi
Barcelona, Barcelona, Spain
Hospital Universitari de Girona Dr. Josep Trueta
Girona, Girona, Spain
Hospital Universitari Arnau de Vilanova de Lleida
Lleida, Lleida, Spain
Hospital de Sant Pau I Santa Tecla
Tarragona, Tarragona, Spain
Disability scale of Kurtzke EDSS score
Time frame: up to day 91
Adverse events / tolerability
Time frame: Baseline and day 29
Disability scale of Kurtzke EDSS score
Time frame: Baseline and day 8
The number and volume of active lesions (measured by the T2 or gadolinium enhancement), the number of new active lesions and the percentage of active lesions at baseline that becomes black holes
Time frame: day -1 and day 29
Adverse events / tolerability
Time frame: Baseline and day 8
Questionnaire MSQOL-54
Time frame: Baseline and day 8
Questionnaire MSQOL-54
Time frame: Baseline and day 29
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