Effect of Pulsed Methylprednisolone on Pain, in Patients with HTLV-1-Associated Myelopathy
HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is an immune mediated myelopathy caused by the human T-lymphotropic virus type 1 (HTLV-1). The efficacy of treatments used for patients with HAM/TSP is uncertain. The aim of this study is to document the efficacy of pulsed methylpre...
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| description | HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is an immune mediated myelopathy caused by the human T-lymphotropic virus type 1 (HTLV-1). The efficacy of treatments used for patients with HAM/TSP is uncertain. The aim of this study is to document the efficacy of pulsed methylprednisolone in patients with HAM/TSP. Data from an open cohort of 26 patients with HAM/TSP was retrospectively analysed. 1g IV methylprednisolone was infused on three consecutive days. The outcomes were pain, gait, urinary frequency and nocturia, a range of inflammatory markers and HTLV-1 proviral load. Treatment was well tolerated in all but one patient. Significant improvements in pain were: observed immediately, unrelated to duration of disease and maintained for three months. Improvement in gait was only seen on Day 3 of treatment. Baseline cytokine concentrations did not correlate to baseline pain or gait impairment but a decrease in tumour necrosis factor-alpha (TNF-α) concentration after pulsed methylprednisolone was associated with improvements in both. Until compared with placebo, treatment with pulsed methylprednisolone should be offered to patients with HAM/TSP for the treatment of pain present despite regular analgesia. |
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The efficacy of treatments used for patients with HAM/TSP is uncertain. The aim of this study is to document the efficacy of pulsed methylprednisolone in patients with HAM/TSP. Data from an open cohort of 26 patients with HAM/TSP was retrospectively analysed. 1g IV methylprednisolone was infused on three consecutive days. The outcomes were pain, gait, urinary frequency and nocturia, a range of inflammatory markers and HTLV-1 proviral load. Treatment was well tolerated in all but one patient. Significant improvements in pain were: observed immediately, unrelated to duration of disease and maintained for three months. Improvement in gait was only seen on Day 3 of treatment. Baseline cytokine concentrations did not correlate to baseline pain or gait impairment but a decrease in tumour necrosis factor-alpha (TNF-α) concentration after pulsed methylprednisolone was associated with improvements in both. Until compared with placebo, treatment with pulsed methylprednisolone should be offered to patients with HAM/TSP for the treatment of pain present despite regular analgesia.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0152557</identifier><identifier>PMID: 27077747</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Aged ; Analgesia ; Biology and life sciences ; Blood & organ donations ; Central nervous system diseases ; Cytokines - metabolism ; Drug dosages ; Female ; Gait ; Genetic aspects ; Health aspects ; Hereditary spastic paraplegia ; Hospitals ; HTLV-I (Virus) ; Human T-lymphotropic virus ; Human T-lymphotropic virus 1 ; Human T-lymphotropic virus 1 - drug effects ; Human T-lymphotropic virus 1 - physiology ; Humans ; Immunology ; Infections ; Inflammation ; Lupus ; Lymphocytes ; Male ; Medicine ; Medicine and Health Sciences ; Methylprednisolone ; Methylprednisolone - pharmacology ; Methylprednisolone - therapeutic use ; Middle Aged ; Multiple sclerosis ; Pain ; Pain - complications ; Pain - drug therapy ; Pain perception ; Paraparesis, Tropical Spastic - complications ; Paraparesis, Tropical Spastic - drug therapy ; Paraparesis, Tropical Spastic - metabolism ; Paraparesis, Tropical Spastic - physiopathology ; Patients ; Retrospective Studies ; Rheumatoid arthritis ; Spastic paraparesis ; Spinal cord ; Studies ; Tropical spastic paraparesis ; Tumor necrosis factor-α ; Tumors ; Urination - drug effects ; Viral Load - drug effects ; Virology ; Viruses ; Walking</subject><ispartof>PloS one, 2016-04, Vol.11 (4), p.e0152557-e0152557</ispartof><rights>COPYRIGHT 2016 Public Library of Science</rights><rights>2016 Buell et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2016 Buell et al 2016 Buell et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c725t-67a3b01e70264c66f6a3bea3a922cdad0e37121710f3af968b044def3c65abc33</citedby><cites>FETCH-LOGICAL-c725t-67a3b01e70264c66f6a3bea3a922cdad0e37121710f3af968b044def3c65abc33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4831674/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4831674/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79472,79473</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27077747$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Nixon, Douglas F.</contributor><creatorcontrib>Buell, Kevin G</creatorcontrib><creatorcontrib>Puri, Aiysha</creatorcontrib><creatorcontrib>Demontis, Maria Antonietta</creatorcontrib><creatorcontrib>Short, Charlotte L</creatorcontrib><creatorcontrib>Adonis, Adine</creatorcontrib><creatorcontrib>Haddow, Jana</creatorcontrib><creatorcontrib>Martin, Fabiola</creatorcontrib><creatorcontrib>Dhasmana, Divya</creatorcontrib><creatorcontrib>Taylor, Graham P</creatorcontrib><title>Effect of Pulsed Methylprednisolone on Pain, in Patients with HTLV-1-Associated Myelopathy</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is an immune mediated myelopathy caused by the human T-lymphotropic virus type 1 (HTLV-1). 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metabolism</topic><topic>Drug dosages</topic><topic>Female</topic><topic>Gait</topic><topic>Genetic aspects</topic><topic>Health aspects</topic><topic>Hereditary spastic paraplegia</topic><topic>Hospitals</topic><topic>HTLV-I (Virus)</topic><topic>Human T-lymphotropic virus</topic><topic>Human T-lymphotropic virus 1</topic><topic>Human T-lymphotropic virus 1 - drug effects</topic><topic>Human T-lymphotropic virus 1 - physiology</topic><topic>Humans</topic><topic>Immunology</topic><topic>Infections</topic><topic>Inflammation</topic><topic>Lupus</topic><topic>Lymphocytes</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Methylprednisolone</topic><topic>Methylprednisolone - pharmacology</topic><topic>Methylprednisolone - therapeutic use</topic><topic>Middle Aged</topic><topic>Multiple sclerosis</topic><topic>Pain</topic><topic>Pain - complications</topic><topic>Pain - drug therapy</topic><topic>Pain perception</topic><topic>Paraparesis, Tropical Spastic - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Buell, Kevin G</au><au>Puri, Aiysha</au><au>Demontis, Maria Antonietta</au><au>Short, Charlotte L</au><au>Adonis, Adine</au><au>Haddow, Jana</au><au>Martin, Fabiola</au><au>Dhasmana, Divya</au><au>Taylor, Graham P</au><au>Nixon, Douglas F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of Pulsed Methylprednisolone on Pain, in Patients with HTLV-1-Associated Myelopathy</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2016-04-14</date><risdate>2016</risdate><volume>11</volume><issue>4</issue><spage>e0152557</spage><epage>e0152557</epage><pages>e0152557-e0152557</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is an immune mediated myelopathy caused by the human T-lymphotropic virus type 1 (HTLV-1). The efficacy of treatments used for patients with HAM/TSP is uncertain. The aim of this study is to document the efficacy of pulsed methylprednisolone in patients with HAM/TSP. Data from an open cohort of 26 patients with HAM/TSP was retrospectively analysed. 1g IV methylprednisolone was infused on three consecutive days. The outcomes were pain, gait, urinary frequency and nocturia, a range of inflammatory markers and HTLV-1 proviral load. Treatment was well tolerated in all but one patient. Significant improvements in pain were: observed immediately, unrelated to duration of disease and maintained for three months. Improvement in gait was only seen on Day 3 of treatment. Baseline cytokine concentrations did not correlate to baseline pain or gait impairment but a decrease in tumour necrosis factor-alpha (TNF-α) concentration after pulsed methylprednisolone was associated with improvements in both. Until compared with placebo, treatment with pulsed methylprednisolone should be offered to patients with HAM/TSP for the treatment of pain present despite regular analgesia.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>27077747</pmid><doi>10.1371/journal.pone.0152557</doi><oa>free_for_read</oa></addata></record> |
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| ispartof | PloS one, 2016-04, Vol.11 (4), p.e0152557-e0152557 |
| issn | 1932-6203 1932-6203 |
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| source | MEDLINE; Public Library of Science; Full-Text Journals in Chemistry (Open access); DOAJ Directory of Open Access Journals; PubMed Central; EZB Electronic Journals Library |
| subjects | Adult Aged Analgesia Biology and life sciences Blood & organ donations Central nervous system diseases Cytokines - metabolism Drug dosages Female Gait Genetic aspects Health aspects Hereditary spastic paraplegia Hospitals HTLV-I (Virus) Human T-lymphotropic virus Human T-lymphotropic virus 1 Human T-lymphotropic virus 1 - drug effects Human T-lymphotropic virus 1 - physiology Humans Immunology Infections Inflammation Lupus Lymphocytes Male Medicine Medicine and Health Sciences Methylprednisolone Methylprednisolone - pharmacology Methylprednisolone - therapeutic use Middle Aged Multiple sclerosis Pain Pain - complications Pain - drug therapy Pain perception Paraparesis, Tropical Spastic - complications Paraparesis, Tropical Spastic - drug therapy Paraparesis, Tropical Spastic - metabolism Paraparesis, Tropical Spastic - physiopathology Patients Retrospective Studies Rheumatoid arthritis Spastic paraparesis Spinal cord Studies Tropical spastic paraparesis Tumor necrosis factor-α Tumors Urination - drug effects Viral Load - drug effects Virology Viruses Walking |
| title | Effect of Pulsed Methylprednisolone on Pain, in Patients with HTLV-1-Associated Myelopathy |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-07T15%3A54%3A31IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effect%20of%20Pulsed%20Methylprednisolone%20on%20Pain,%20in%20Patients%20with%20HTLV-1-Associated%20Myelopathy&rft.jtitle=PloS%20one&rft.au=Buell,%20Kevin%20G&rft.date=2016-04-14&rft.volume=11&rft.issue=4&rft.spage=e0152557&rft.epage=e0152557&rft.pages=e0152557-e0152557&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0152557&rft_dat=%3Cgale_plos_%3EA453448185%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1781146453&rft_id=info:pmid/27077747&rft_galeid=A453448185&rft_doaj_id=oai_doaj_org_article_b84db5bdeedf4bca9558531c9a01b414&rfr_iscdi=true |