Deltasone (prednisone) is a corticosteroid. It prevents the release of substances that cause inflammation and also suppresses the immune system. The therapy is used to treat many conditions including allergic reactions, breathing difficulties, occasional symptoms of certain cancers, and relapse management in multiple sclerosis (MS).

Corticosteroids works in MS relapse management by closing the damaged blood-brain barrier and reducing inflammation in the central nervous system.

MS patients generally take a three- to five-day treatment of high dose intravenous corticosteroid followed by a gradual dose reduction via an oral corticosteroid (may last from 10 days to five or six weeks). Prednisone is usually the choice for this oral tapering off.

It may also be used orally if the corticosteroid for intravenous treatment is not desired or is contraindicated.

Prednisone should not be taken if a fungal infection is present. Because it weakens the immune system, people taking prednisone shouldn’t be around others who are sick or who have infections.

Some common side effects associated with prednisone include insomnia, mood changes, increased appetite, gradual weight gain, acne, increased sweating, skin problems, difficulties with healing wounds, headache, nausea and gastric disorders, and changes in the shape or location of body fat.

Other prednisone brands are Rayos, Sterapred, Sterapred DS, and Prednicot.

Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

 

  1. https://www.drugs.com/prednisone.html
  2. https://medlineplus.gov/druginfo/meds/a601102.html#brand-name-1
  3. http://www.nationalmssociety.org/Treating-MS/Medications/Deltasone
  4. https://www.drugs.com/imprints/deltasone-10-206.html

#ECTRIMS2018 – Study Examines Relapses When Stopping Gilenya During, After Pregnancy

Up to half of women with multiple sclerosis (MS) who stop treatment with Gilenya (fingolimod) when planning to become pregnant will experience a relapse during pregnancy, according to a new study.

The findings also revealed relapses over the first six months after giving birth in a quarter of women who stopped Gilenya before or after getting pregnant.

The research, “Disease activity during pregnancy after fingolimod withdrawal due to planning a pregnancy in women with multiple sclerosis,” was presented at the 34th congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), which took place Oct. 10-12, in Berlin, Germany.

The data were presented by Spalmai Hemat, from St. Josef Hospital, Ruhr University of Bochum, Germany.

Previous studies have shown that the frequency of symptoms’ worsening (relapses) in MS patients declines during pregnancy, creating a sort of natural protection. “In pregnant women with MS, disease activity significantly decreases, especially in the third trimester” Hemat said in the presentation.

However, women with MS who stop treatment with Novartis’ Gilenya and are planning to become pregnant have an unknown risk for relapse or disability, although severe return of disease activity had been described.

Aiming to address this gap, a team from Germany, U.S., Spain, Austria, Italy, and Belgium compared the relapse rate, disability risk, and pregnancy outcomes in women who stopped Gilenya treatment either before (group A) or after (group B) becoming pregnant.

Researchers collected detailed data on the course of MS and pregnancy, relapses, disability, and outcome from the German MS and pregnancy registry (140 patients) and from six international collaborators (16 patients) up to September 2017. Six pregnancies were ongoing when the study finished.

The analysis revealed that 46 women in group A stopped Gilenya 295 days (range 61-312 days) before the last menstrual period (LMP). In group B, 110 women had a median Gilenya exposure of 35.4 days (range 1-123 days) after their LMP.

Ten (21.7%) women in group A had a relapse between stopping Gilenya and becoming pregnant. Group A also showed a higher percentage of women with relapses during pregnancy. According to Hemat, “up to 50% of women treated with Gilenya before or up to pregnancy will experience a relapse during pregnancy.”

She also added that “women who stopped Gilenya for more than 2 months prior to the last LMP, experience more relapses before pregnancy and at the beginning of pregnancy.”

Expanded Disability Status Scale (EDSS) score remained stable and did not indicate permanent disability in most patients, although one woman in group A (5.13%) and nine in group B (7.69%) experienced a marked worsening of two or more EDSS points six months postpartum. (The greater the EDSS score, the worse is the patient’s level of disability.)

“The large majority of women will not experience permanent disability,” Hemat said, “but up to 10-20% will suffer from substantial EDSS worsening 6 months postpartum.”

The 31 patients who restarted Gilenya treatment during the first 30 days postpartum had an insignificant reduction in relapse risk during the first six months.

The only significant predictor for relapses postpartum were relapses during pregnancy.

Overall, the team concluded that, despite the natural protection of pregnancy, up to half of women treated with Gilenya before or up to pregnancy will experience a relapse during pregnancy.

According to Hemat, “more data are needed to investigate if very early (first 14 days) postpartum treatment with Gilenya might reduce postpartum relapse risk.”

Of note, four of the study’s authors received funding/fees from Novartis.

#ECTRIMS2018 — Early Relapses and Larger Lesions Increase Risk of Developing SPMS, Study Reports

A higher frequency of early relapses, as well as a larger volume of lesions and older age at disease onset, increase the risk of transitioning from relapsing-remitting multiple sclerosis (RRMS) to secondary progressive MS (SPMS), according to a study. The study, “Early cortical pathology and early relapses predict the risk of developing secondary progressive MS,” […]

#AAN2018 – New AAN Guideline Favors Advising Patients to Use DMTs Early in Disease Course

A new American Academy of Neurology (AAN) guideline recommends that multiple sclerosis (MS) patients in general be counseled to start treatment with disease-modifying therapies (DMTs) as early as possible. Considerations on switching and stopping treatments are also presented in the guideline. The report, “Practice guideline recommendations summary: Disease-modifying therapies for adults with multiple sclerosis: Report […]

Pain Treatment During Labor Does Not Increase Risk of MS Relapses After Delivery, Study Finds

A certain type of pain-relief treatment during childbirth does not increase the risk that women with multiple sclerosis will have relapses after delivering, a European study reports. The research involved treatments called neuraxial analgesia, so the scientists titled their study “Neuraxial analgesia is not associated with an increased risk of post-partum relapses in MS.” It appeared in […]

Blood Stem Cell Transplants Improve RRMS Patients’ Disability, Phase 3 Trial Shows

Blood stem cell transplants lead to significant improvements in relapsing-remitting multiple sclerosis patients’ disability, a Phase 3 clinical trial shows. The 110 patients who took part in the MIST study (NCT00273364) were having relapses after receiving standard therapies such as beta interferon, Copaxone (glatiramer acetate), Novantrone (mitoxantrone), Tysabri (natalizumab), Gilenya (fingolimod), and Tecfidera (dimethyl fumarate). Half the […]

Poorer Sense of Smell Can Be Evident Even in Early Stages of MS, Study Says

People with multiple sclerosis (MS) can indeed have a poorer-than-usual sense of smell, with problems possibly starting at early diseases stages, a small Turkish study reports. This work supports previous research noting olfactory problems in MS patients. It also argues that longer disease duration and more relapses are associated with greater difficulties, reflecting “more extensive […]

Newly Diagnosed MS Patients Stay Longer on Rituxan Than Other Therapies, Study Finds

Multiple sclerosis patients whose first treatment is Genentech’s Rituxan (rituximab) stay on it longer than other disease-modifying drugs that patients start with, a Swedish study reports.

When they stop taking Rituxan,  it usually isn’t for lack of effectiveness or side effects — the reasons that lead to the discontinuation of the other drugs, according to the Karolinska Institutet researchers.

They also said that patients on Rituxan have fewer relapses and fewer new brain lesions than those on other therapies. Brain lesions are areas where the myelin sheath that protects nerve cells has deteriorated.

The team wanted to explore differences in patients’ discontinuation of Rituxan, compared with other treatments. The study covered newly diagnosed relapsing-remitting MS patients in two counties in Sweden — Västerbotten and Stockholm.

Their work, “Comparative Effectiveness of Rituximab and Other Initial Treatment Choices for Multiple Sclerosis,” appeared in the journal JAMA Neurology.

The study covered 494 patients with relapsing-remmitting MS whose median age of 34.4 years.

Rituxan was neurologists’ drug of choice as a first-line treatment for patients in Västerbotten County, which is in northern Sweden. Eighty-one 81 percent of patients there were taking it.

In contrast, only 18 percent of patients in Stockholm County in the south were receiving Rituxan.

Treatments that other patients were taking included the injected drugs interferon beta and Copaxone (glatiramer acetate), Gilenya (fingolimod), Tecfidera (dimethyl fumarate), and Tysabri (natalizumab). Copaxone’s maker is Teva Neuroscience, Gilenya’s is Novartis, and Tecfidera and Tysabri’s is Biogen.

Patients taking Rituxan stayed on it significantly longer than other patients stuck with their drugs, researcher discovered. Among 120 patients treated with Rituxan, only seven quit during the four-year study period.

The main reason for discontinuation in four of the patients was pregnancy. One patient quit because their disease improved, and one because of side effects.

Researchers said patients on the injected therapies Tecfidera and Gilenya had the highest rates of discontinuing treatment due to their disease worsening or side effects. Thirty-eight percent stopped because their disease worsened and  28 percent because of side effects.

The main reason that Tysabri-treated patients quit was because tests showed they had John Cunningham virus. The virus is usually dormant. A compromised immune system can lead to it causing a lfe-threatening brain disease known as progressive multifocal leukoencephalopathy. A third of the patients on Tysabri tested positive for the virus.

Another finding was that increases in relapse rates and new brain lesions were more common in patients using treatments other than Rituxan.

In addition, patients taking injected therapies experienced mild side effects more often than those on Rituxan. Rates of moderate and severe adverse events were similar in the two groups.

“Collectively, our findings suggest that Rituximab performs better than other commonly used DMTs [disease-modifying drugs] in patients with newly diagnosed RRMS,” the researchers wrote.

While the study offered a glimpse of the effectiveness and safety of these drugs in a real-world setting, the team said more research of this kind is needed.

 

Ozanimod Superior to Avonex in Treating Relapsing MS in Phase 3 Trials, Celgene Reports

Celgene released the results of two Phase 3 trials showing that patients with relapsing multiple sclerosis (MS) who were treated with ozanimod had lower relapse rates and fewer MRI brain lesions compared to those given a current first-line therapy, Avonex (interferon β-1a).

These results will be used to support a request for ozanimod’s approval as an MS therapy  with the U.S. Food and Drug Administration (FDA), a filing known as a  New Drug Application.

The therapy — invented by scientists at The Scripps Research Institute  in San Diego — selectively targets two receptors, the sphingosine 1-phosphate 1 (S1PR1) and 5 (S1PR5), and shows similar action to the Avonex, an intramuscular injection of interferon beta-1a marketed by Biogen.

S1PR1 and S1PR5 receptors are located at the surface of certain immune cells, and blocking them is a way of curtailing the inflammatory process.

The Phase 3 RADIANCE Part B study goal was to determine the annualized release rate in relapsing MS patients treated with one of two doses of oral ozanimod — 1 mg and 0.5 mg — administered daily and compared to patients who received an Avonex weekly injection. All were evaluated over a two-year treatment period. The study enrolled 1,320 patients with relapsing MS at 147 sites in 21 countries.

In the Phase 3 SUNBEAM trial , researchers measured the annualized relapse rate after patients received the same doses of oral ozanimod (1 mg or 0.5 mg) for at least one year, compared to those given Avonex. The multicenter, international study enrolled 1,346 patients in 20 countries.

Data from these studies showed that both doses of ozanimod significantly reduced the annualized relapse rate, and the reduction was superior to that achieved with Avonex.

A significant reduction in the number of gadolinium-enhanced MRI lesions and new or enlarging T2 lesions after one year of treatment was also observed in ozanimod-treated patients relative to those treated with Avonex.

Finally, both doses of the therapy significantly slowed brain volume loss — a feature that signals disease progression and cognitive impairment — compared to Avonex.

“Ozanimod’s ability to inhibit brain atrophy promises patients a long and productive life, living with relapsing, remitting multiple sclerosis without disability,” Hugh Rosen, MD, a TSRI professor of Molecular Medicine and co-inventor of ozanimod, said in a press release. “This is truly disease-modifying.”

Celgene hopes to have ozanimod available to patients by late 2018, pending FDA approval.

Ozanimod was discovered and first developed in an academic setting, as part of the National Institutes of Health’s (NIH) Molecular Library Initiative, and is the first such discovery to successfully complete Phase 3 clinical trials.

“The success of ozanimod shows that academia and the NIH can make transforming discoveries that benefit patients and those that care for them,” Rosen said.

Celgene is also evaluating ozanimod’s potential in other diseases, including autoimmune and rheumatological conditions. Currently, the company has ongoing Phase 3 trials for ulcerative colitis, and recently released data from a Phase 2 study in Crohn’s disease.

 

MS Relapses May Be Significantly Under-Reported. Duh.

This comes as no surprise to me and probably not to you. MS patients may not always contact their healthcare providers when they’re having a relapse. This information comes via a pair of surveys that were released at the recent ECTRIMS-ACTRIMS conference in Paris. In the first, Health Union questioned 5,311 patients in the U.S. […]