Repeated Intrathecal Triamcinolone Acetonide Administration in Progressive Multiple Sclerosis: A Review

Table 2

Representative intrathecal steroid investigations in multiple sclerosis (since 2003).

	Design	Patients included, MS type	Dosage and duration	Primary and secondary outcomes	Results	Evidence
Hoffmann et al., 2003 [37]	Open-label, prospective, uncontrolled, unblinded, short follow up	36 (SP, PP)	TCA 40 mg/6 times within 3 weeks; follow up with 40 mg every 6–12 weeks; 13.1 ± 6.22, 3–23 (mean ± SD., range) months	EDSS WD	initial phase: EDSS (initial 5.6 ± 0.93 (mean ± S.D.); end: 4.9 ± 1.0; 𝑃<.001).; WD: (initial: 294 ± 314 m; end: 604 ± 540 m; 𝑃<.001) follow up: EDSS and WD remained stable	IV
Hellwig et al., 2004 [38]	Open-label, prospective, uncontrolled, unblinded, short follow up	161 (RR, SP, PP)	TCA 40 mg/6 times within 3 weeks	EDSS WD SSEP	EDSS: (initial: 6.44 ± 1.06; end: 5.47 ± 1.24): WD: (initial 158.03 ± 501.20, end: 439.38 ± 895.24).; SSEP latencies: reduced for all variables (𝑃<.0001)	IV
Hoffmann et al., 2006 [39]	Open-label, prospective, uncontrolled, unblinded, short follow up	27 (SP, PP)	TCA 40 mg/6 times within 3 weeks	EDSS WD WT 25-f-test CSF changes	EDSS: (initial: 5.4 ± 1.3; end: 4.9 ± 1.1; 𝑃<.001).; WD and WT increased: 𝑃<.001, 25 f-test increased: 𝑃<.01 CSF changes n.s.	IV
Hellwig et al., 2006 [40]	open-label over a 52-week long interval, prospective, randomized, unblinded	TCA: 34 (SP, PP); MIX: 30 (SP, PP)	TCA: 40 mg every 6–12 weeks, 52 weeks; MIX: initial dose: 12 mg/m^2 2nd dose: 8–10 mg/m^2 6 weeks later/then quarterly: 52 weeks	EDSS WD	TCA: EDSS decreased (𝑃<.001); WD: increased (𝑃<.001); MIX: EDSS, WD n.s.	III

TCA: triamcinolone-acetonide acid; RR: relapsing-remitting MS; PP: primary chronic progressive MS; SP: secondarychronic progressive MS; MIX: mitoxantrone; EDSS: expanded disability status scale; WD: maximum walking distance; WT: maximum walking time; SSEP: somatosensory evoked potentials; CSF: cerebrospinal fluid; n.s: non significant.