Dissertation committee:
Μαρία Αλεβιζάκη, Ομότιμη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Γρηγόριος Καλτσάς, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ευάγγελος Τέρπος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ευανθία Κασσή, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ευρύκλεια Λιανίδου, Καθηγήτρια, Τμήμα Χημείας, ΕΚΠΑ
Μαρία Αναγνωστούλη, Μόνιμη Επίκουρη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Αθηνά Μάρκου, Επίκουρη Καθηγήτρια, Τμήμα Χημείας, ΕΚΠΑ
Summary:
Background: High-dose intravenous steroid treatment (HDIST) represents the first choice of treatment for multiple sclerosis (MS) relapses. Chronic oral glucocorticoid (GC) administration correlates with bone loss whereas data regarding HDIST in MS are still conflicting.
Methods: Twenty-five newly diagnosed MS patients (NDMSP) (median age: 37 years, range: 18 - 45 years) were prospectively studied for the effects of HDIST on bone mineral density (BMD) and bone metabolism. Patients received 1000mg methylprednisolone, intravenously, daily for 5 days followed by oral prednisolone tapering over 21 days. Bone metabolism indices were determined prior to GC and then on days 2, 4, 6 and 90 and at months 6, 12, 18 and 24 post GC therapy. Femoral, lumbar-spine BMD and whole-body measurement of adipose/lean tissue were assessed prior to GC-administration and then every six months.
Results: Ten patients completed the study. N-terminal-propeptide-procollagen-type-1 and bone-specific alkaline phosphatase showed a significant increase at day-90 (p<0.05). A transient non-significant fall of BMD was observed at 6 months after GC-administration, which subsequently appeared to be restored.
Conclusions: HDIST seems not to have long-term negative effects on BMD, while the observed transient increase of bone formation markers probably indicates a high bone turnover phase to GC-administration. Additional prospective studies with larger sample size are needed.
