Decadron (dexamethasone) is a glucocorticosteroid with anti-inflammatory action, orally administered. The therapy helps in treating the acute exacerbations associated with relapsing forms of multiple sclerosis (MS).
How Decadron Works
Researchers believe that Decadron’s mechanism of action is mainly anti-inflammatory in nature, and that it also works as an immunosuppressor. However, the therapy’s exact workings in the body are not completely understood.
A study verified that the mechanisms of action of systemic corticosteroids in the treatment of acute MS relapses are thought to be attributed to immunologic alterations, including the reduction of lymphocyte counts and their presence at inflammatory sites. This could result in a decreased number of IgG synthesizing cells in the central nervous system (CNS), and may reduce the blood-brain-barrier’s abnormally increased permeability (and decrease of active lesions). [1,2,3]
Clinical Trials for Decadron
A double-blinded, randomized trial compared dexamethasone to adrenocorticotropic hormone (ACTH) and methylprednisolone (MP). The study included 30 patients divided into three groups: 1) ACTH, 50 units/day for 7 days, then 25 units/day for 4 days, and then 12.5 units/day for 3 days; 2) dexamethasone, 8 mg/day for 7 days, then 4 mg/day for 4 days, and then 2 mg/day for 3 days; 3) MP, 40 mg/day for 7 days, then 20 mg/day for 4 days, and then 10 mg/day for 3 days. Each dose was administered by intravenous infusion in 250 ml of saline solution. Dexamethasone-treated patients showed better clinical improvement than those in other groups, the study found, and dexamethasone seemed to be the most effective of the three drugs studied.
The recommended dose in the treatment of acute exacerbations of MS is 30 mg of dexamethasone (daily) for a week, followed by 4 to 12 mg every other day for one month. Adverse reactions include allergic reactions, cardiovascular, dermatological, endocrine, gastrointestinal, metabolic, neurological and ophthalmic problems.
Next Steps for Decadron
There are currently ongoing trials studying the effectiveness of new combination therapies that include Decadron in a number of diseases.
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1 – Corticosteroids for multiple sclerosis: I. Application for treating exacerbations; Frohman EM, Shah A, Eggenberger E, Metz L, Zivadinov R, Stüve O; Neurotherapeutics. 2007 Oct
2 – High-dose intravenous methylprednisolone in the treatment of multiple sclerosis: clinical-immunologic correlations; Durelli L, Cocito D, Riccio A, Barile C, Bergamasco B, Baggio GF, Perla F, Delsedime M, Gusmaroli G, Bergamini L; Neurology. 1986 Feb
3 – A short-term randomized MRI study of high-dose oral vs intravenous methylprednisolone in MS; Martinelli V, Rocca MA, Annovazzi P, Pulizzi A, Rodegher M, Martinelli Boneschi F, Scotti R, Falini A, Sormani MP, Comi G, Filippi M; Neurology. 2009 Dec 1