The effect of ACTH and

corticosteroid therapy on the

Draen Stojanovi1, Diana Debeli2, Juraj Sepi3

1. Institute of Public Health, Rijeka University Medical School

progression of disability in

2. Clinical Hospital Center

3. Clinical Hospital Center, Rijeka University Medical School

multiple sclerosis

Objective

To investigate the influence of the ACTH and corticosteroid therapy

on the progression of disability in multiple sclerosis (MS) patients.

Material and methods

TIME FROM MODERATE TO SEVERE DISABILITY

A group of 124 clinically definite MS patients from Croatia was

TIME OF DEVELOPMENT OF THE MODERATE DISABILITY

postmortem divided in two subgroups, depending on wether they

had or had not received ACTH or corticosteroid therapy during the

GORSKI KOTAR

GORSKI KOTAR

OTHERS

OTHERS

MS relapses. The patients from the each subgroup were further

divided depending on wether they came from disease high- (Gorski

WITH ACS
WITH ACS

kotar) or low- (Others) risk area.

Corticotropin was administered intravenously (i.v.) in dose of 100
units a day during the first week, 75 units a day during the second,

WITHOUT ACS
WITHOUT ACS

0,0

2,0

4,0

6,0

50 units a day during the third and 25 units a day during the fourth

8,0

10,0

12,0

YEARS
0,0

1,0

2,0

3,0

4,0

5,0

6,0

7,0

8,0

YEARS

week of therapy. Methylprednisolone sodium succinate was

administered in dose of 0,5 gram i.v. daily for 5-7 days. EDSS was
used in assessment of patients' disability. The result were evaluated
by t-test for independent samples, p-values less than 0,05 were
considered statistically significant.

DURATION OF THE DISEASE

Results

TIME OF DEVELOPMENT OF THE SEVERE DISABILITY

GORSKI KOTAR
OTHERS

GORSKI KOTAR

ACTH or corticosteroids treated MS patients developed moderate

OTHERS

(EDSS <4) as well as severe (EDSS 4-8) disability before non-

WITH ACS

treated patients (p<0,05). In excepton for ACTH or corticosteroids

WITH ACS

treated group in reaching the moderate disability, patients (ACTH or

WITHOUT ACS

corticosteroids treated and those non treated) from the low risk area
WITHOUT ACS

0,0

developed moderate as well as severe disability before those from

the high-risk area.

5,0

10,0

15,0
YEARS

0,0

5,0

10,0

15,0

20,0

YEARS

Conclusion

MS patients on ACTH or corticosteroid therapy during the MS

relapses showed significantly faster disability progression in
comparison to the non-treated. This was much more remarkable
among the patients from the disease low-risk area.

25,0

30,0

20,0

25,0