Clinical Profile and Predictors of Corticosteroid-Related Adverse Effects in Patients with Multiple Sclerosis

INTRODUCTION: High-dose intravenous methylprednisolone (IVMP) is widely recommended as first-line therapy for clinically significant relapses in multiple sclerosis (MS). Despite its well-established efficacy in accelerating neurological recovery, treatment is frequently accompanied by a variety of adverse effects that may influence patient comfort, adherence, and overall quality of life. However, the frequency, clinical spectrum, and determinants of these corticosteroid-related adverse effects have not been comprehensively evaluated in routine clinical practice
METHODS: To determine the frequency of corticosteroid-related adverse effects and identify independent predictors of the overall adverse effect burden in patients with multiple sclerosis receiving high-dose intravenous methylprednisolone. In this prospective observational study, 71 patients with clinically definite MS treated with high-dose IVMP for acute relapse were enrolled. Corticosteroid-related adverse effects were assessed using a standardized questionnaire, and demographic and clinical variables were analyzed using Spearman correlation and multivariable linear regression.

RESULTS: The most frequently reported adverse effects were fatigue (77.5%), metallic taste (70.4%), muscle weakness (66.2%), mood disturbance (53.5%), hot flushes (49.3%), and insomnia (46.5%). BMI showed a significant positive correlation with the total adverse effect score (ρ = 0.362, p = 0.002) and remained the only independent predictor of the overall adverse effect burden in the multivariable regression analysis (standardized β = 0.361, p = 0.003).
DISCUSSION AND CONCLUSION: Corticosteroid-related adverse effects are common among patients with multiple sclerosis receiving high-dose intravenous methylprednisolone therapy. BMI was identified as the only independent predictor of the overall adverse effect burden, suggesting that patients with higher BMI may benefit from closer clinical monitoring during relapse treatment.

Keywords: Multiple sclerosis, Intravenous methylprednisolone, Corticosteroid-related adverse effects, Body mass index,