Neurology Medical News about intravenous methylprednisolone;multiple sclerosis relapses;home administration

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Home administration of intravenous methylprednisolone for multiple sclerosis relapses: the experience of French multiple sclerosis networks
Multiple Sclerosis, 06/30/09

Creange A et al. – Safety data, pt satisfaction, and economic considerations support home-based treatment of multiple sclerosis (MS) relapses with intravenous methylprednisolone, provided strict pt selection criteria are observed and the process is coordinated and closely monitored by an MS network.

Methods

Report of a multi-center series of MS pts treated at home for a relapse with a 3-day course of intravenous (IV) methylprednisolone
Home administration of intravenous methylprednisolone coordinated by 4 MS networks in France
Relapsed MS pts referred by neurologists
Treatment administered by local nurse
Analysis of safety and efficiency of this approach
Estimation of related cost savings
Pt satisfaction questionnaire for all pts

Results

IV methylprednisolone at home for 807 pts
Mean disease duration: 10.3 ± 7.9 yrs
Treatment often prescribed by community-based neurologists
Delay between prescription and treatment: 2.8 ± 0.5 days if treatment initiated at home vs 1.9 ± 3.0 days if treatment initiated in hospital (subsequent 2 injections always at home)
Home treatment: well tolerated
Serious side effects requiring hospital transfer: anxiety, thoracic oppression, and arrhythmia; all fully reversible
Overall, 93.8% of pts satisfied with treatment approach; 98% wished to receive future treatment courses at home
Overall cost savings of home-based treatment vs hospital-based treatment evaluated at EUR1,091,482

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