Abstract
Objectives:
Multiple sclerosis (MS) is an autoimmune disease affecting young people and is a major cause of disability. In the course of time, disability progresses and symptoms like spasticity may occur. Spasticity is a major cost factor in MS patients. Various agents are approved for the treatment of spasticity, but each of those agents may have several side effects. Intrathecally administered steroids (triamcinolone-acetonide (TCA)) may be efficient in treating spasticity in patients with lesions in the spinal cord and no response to first-line therapeutics. The aim of this study is to show effects of TCA treatment on clinical parameters in patients with MS.
Methods:
This multicentre open label study included 54 patients with MS. The clinical outcome parameters were spasticity, disability, maximum walking distance, bladder function and quality of life. All patients received physiotherapy in addition to TCA treatment to obtain optimal effects on clinical parameters.
Results:
Spasticity, maximum walking distance as well as disability improved significantly (P⩽0.001) during TCA applications. Bladder function improved in every seventh patient.
Conclusion:
We observed the effects of intrathecally administered TCA on different clinical parameters including bladder function. TCA administration is a safe method to treat different symptoms in MS patients. Longitudinal trials with repeated TCA cycles are needed to show long-term effects. Besides TCA treatment, physiotherapy contributes to the improvement of clinical parameters.
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Acknowledgements
We thank Ms Nele Gillwaldt for providing figures.
Author contributions: FK contributed to the design and conceptualisation of the study, analysis and interpretation of the data, conducted the statistical analysis, and revised the manuscript. PSR contributed to the design and conceptualisation of the study, analysis and interpretation of the data, drafted the manuscript, and revised the manuscript. FK and PSR contributed equally to this research paper, and are both listed as first authors. MAM WK, FH, AW and RB contributed to the analysis and interpretation of the data, and revising the manuscript. UKZ contributed to the design and conceptualisation of the study, analysis and interpretation of the data, and revising the manuscript.
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PSR served as consultant to Bayer Pharma AG and received speaker honorary from Shire. He received travel support from Biogen Idec. He has recently entered employment with Novartis. WK received travel support, research grant and speaker fees from Biogen Idec, Bayer Healthcare, Merck-Serono, Novartis and Teva. FH received travel support from Bayer Healthcare and Biogen Idec; received research grants from Allergan, Bayer Healthcare, Biogen Idec, Genzyme, Ipsen, Merz, Novartis, Teva and UCB; received speaker or consultant fees from Allergan, Bayer Healthcare, Biogen Idec, Genzyme, Ipsen, Merz, Novartis and Teva. AW received travel support from Novartis and Genzyme; received speaker and consultant fees from Merck-Serono and Genzyme. UKZ received speaker fees from Almirall,Bayer Healthcare, Biogen Idec, Genzyme, Merck-Serono, Novartis, Sanofi and Teva. The remaining authors declare no conflict of interest.
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Kamin, F., Rommer, P., Abu-Mugheisib, M. et al. Effects of intrathecal triamincinolone-acetonide treatment in MS patients with therapy-resistant spasticity. Spinal Cord 53, 109–113 (2015). https://doi.org/10.1038/sc.2014.155
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DOI: https://doi.org/10.1038/sc.2014.155
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