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J Neurol Neurosurg Psychiatry. 2007 Aug;78(8):886-8. Epub 2006 Oct 20.

Chronotherapy using corticosteroids for multiple sclerosis relapses.

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  • 1Division of Neuroimmunology, Multiple Sclerosis Center, Carmel Medical Center, 7 Michal Street, Haifa 34362, Israel.

Abstract

BACKGROUND:

The activity of the immune system displays a circadian rhythm. In diseases characterised by aberrant immune activity, chronotherapy (a treatment regimen tailored to diurnal body rhythms) may increase the efficiency, safety and tolerability of drugs.

AIM:

To compare the outcomes of intravenous corticosteroid administration during the day or night, for treatment of acute multiple sclerosis relapses.

METHODS:

17 patients with multiple sclerosis were included in the study. Clinical assessment of disability was performed at trial entry, and at days 7 and 30 from the initiation of treatment. Adverse events and preference of night-time versus daytime treatment were assessed at the end of the treatment course.

RESULTS:

After night-time treatment, clinical recovery was significantly (p<0.001) enhanced and the mean number of side effects was significantly (p = 0.007) lower. Furthermore, most patients expressed a preference for night-time versus daytime treatment.

CONCLUSIONS:

The study suggests a potential benefit for implementation of chronotherapy using steroid treatment for acute multiple sclerosis relapse, with implications for other immune-mediated disorders.

Comment in

PMID:
17056624
[PubMed - indexed for MEDLINE]
PMCID:
PMC2117717
Free PMC Article
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