Effects of intrathecal triamincinolone-acetonide treatment in MS patients with therapy-resistant spasticity

Spinal Cord. 2015 Feb;53(2):109-13. doi: 10.1038/sc.2014.155. Epub 2014 Sep 16.

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.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Combined Modality Therapy
  • Disability Evaluation
  • Female
  • Glucocorticoids / adverse effects*
  • Humans
  • Injections, Spinal
  • Male
  • Middle Aged
  • Multiple Sclerosis, Chronic Progressive / drug therapy*
  • Multiple Sclerosis, Chronic Progressive / physiopathology
  • Multiple Sclerosis, Chronic Progressive / rehabilitation
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy*
  • Multiple Sclerosis, Relapsing-Remitting / physiopathology
  • Multiple Sclerosis, Relapsing-Remitting / rehabilitation
  • Muscle Spasticity / drug therapy*
  • Muscle Spasticity / physiopathology
  • Muscle Spasticity / rehabilitation
  • Quality of Life
  • Treatment Outcome
  • Triamcinolone Acetonide / administration & dosage*
  • Triamcinolone Acetonide / adverse effects
  • Walking

Substances

  • Glucocorticoids
  • Triamcinolone Acetonide