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Scientific Reports Jul 2023Methylprednisolone sodium succinate (MPSS) is a parenteral water-soluble corticosteroid ester. It gives three peaks methylprednisolone (MP), 17-methylprednisolone...
Methylprednisolone sodium succinate (MPSS) is a parenteral water-soluble corticosteroid ester. It gives three peaks methylprednisolone (MP), 17-methylprednisolone hemisuccinate (17-MPHS), and methylprednisolone hemisuccinate (MPHS) that share in the assay determination as total MP. It is used on a wide scale in prescribed anti-inflammatory drugs as a common use. The current study aimed to find a rapid RP-HPLC method of MP and its derivatives analysis with high linearity, repeatability, sensitivity, selectivity, and inexpensive to use without the need for any special chemical reagents. The use of the current method achieved a satisfactory result to detect, determine and separate the MP, 17-MPHS, and MPHS in a short time. The chromatographic system consists of RP-HPLC using the BDS column (250 mm × 4.6 mm × 5 μm). The mobile phase was prepared by mixing the WFI: glacial acetic acid: acetonitrile in a volume ratio (63:2:35) at a flow rate of 2.0 mL/min with detection wavelength at 254 nm at room temperature and injection volume 20 μL. The method manifested a satisfied linearity regression R (0.9998-0.99999) with LOD 143.97 ng/mL and 4.49 µg/mL; and LOQ 436.27 ng/mL and 13.61 µg/mL for MP and MPHS respectively. The method proved its efficiency via system suitability achievement in the robustness and ruggedness conduction according to the validation guidelines. High sensitivity according to its LOD and LOQ. So, the current method could be considered in the pharmaceutical industry. The suggested method has been successfully implemented in the Egyptian local market for the quantitative assessment of the assay of the finished product.
Topics: Methylprednisolone; Methylprednisolone Hemisuccinate; Chromatography, High Pressure Liquid; Anti-Inflammatory Agents; Egypt
PubMed: 37460790
DOI: 10.1038/s41598-023-38539-2 -
Medicina (Kaunas, Lithuania) Oct 2019: BTK and BCL2 inhibitors have changed the treatment paradigms of high-risk and elderly patients with chronic lymphocytic leukemia (CLL), but their long-term efficacy...
: BTK and BCL2 inhibitors have changed the treatment paradigms of high-risk and elderly patients with chronic lymphocytic leukemia (CLL), but their long-term efficacy and toxicity are still unknown and the costs are considerable. Our previous data showed that Rituximab (Rtx) and high-dose methylprednisolone (HDMP) can be an effective and safe treatment option for relapsed high-risk CLL patients. : We explored the efficacy and safety of a higher Rtx dose in combination with a shorter (3-day) schedule of HDMP in relapsed elderly or unfit CLL patients. : Twenty-five patients were included in the phase-two, single-arm trial. The median progression free survival (PFS) was 11 months (range 10-12). Median OS was 68 (range 47-89) months. Adverse events (AE) were mainly grade I-II° (77%) and no deaths occurred during the treatment period. : 3-day HDMP and Rtx was associated with clinically meaningful improvement in most patients. The median PFS in 3-day and 5-day HDMP studies was similar and the toxicity of the 3-day HDMP schedule proved to be lower. The HDMP and Rtx combination can still be applied in some relapsed high-risk and elderly or unfit CLL patients if new targeted therapies are contraindicated or unavailable. (ClinicalTrials.gov identifier: NCT01576588).
Topics: Aged; Aged, 80 and over; Antineoplastic Agents; Female; Humans; Leukemia, Lymphocytic, Chronic, B-Cell; Male; Methylprednisolone; Prospective Studies; Rituximab
PubMed: 31671877
DOI: 10.3390/medicina55110719 -
Is high dose intravenous methylprednisolone pulse therapy in patients with Graves' orbitopathy safe?Endokrynologia Polska 2014High dose intravenous glucocorticoid pulse (i.v. GCS) therapy is a proven approach in patients with active, moderate to severe Graves' orbitopathy (GO) and dysthyroid... (Review)
Review
High dose intravenous glucocorticoid pulse (i.v. GCS) therapy is a proven approach in patients with active, moderate to severe Graves' orbitopathy (GO) and dysthyroid optic neuropathy (DON). In moderate to severe GO, the European Group on Graves' Orbitopathy (EUGOGO) recommends a 12-week course of intravenous methylprednisolone (i.v. MP) pulse therapy with a cumulative dose of 4.5 g. The response rate of i.v. GCS treatment is significantly higher than oral glucocorticoid (oral GCS) therapy and is associated with fewer adverse events. However, a major concern was raised because of reports of fatal side effects which may be associated with this therapy, especially when single and cumulative doses of methylprednisolone (MP) are higher than recommended. The prevalence and severity of adverse effects during treatment have not been fully described. The aim of this review was to summarise the frequency of major adverse effects of i.v. GCS compared to oral GCS and attempt to propose some practical suggestions as to how to monitor and prevent the development of side effects.
Topics: Administration, Intravenous; Anti-Inflammatory Agents; Dose-Response Relationship, Drug; Graves Ophthalmopathy; Humans; Methylprednisolone; Orbit; Severity of Illness Index; Treatment Outcome
PubMed: 25301492
DOI: 10.5603/EP.2014.0056 -
Medicina Clinica Feb 2023To compare the 30-day outcome (mortality and/or ICU admission) of patients admitted for moderate-severe SARS-CoV-2 pneumonia treated with dexamethasone after the...
OBJECTIVES
To compare the 30-day outcome (mortality and/or ICU admission) of patients admitted for moderate-severe SARS-CoV-2 pneumonia treated with dexamethasone after the Recovery study versus those treated with weight-adjusted methylprednisolone.
METHODS
Retrospective cohort study of 65 patients with moderate-severe pneumonia who received dexamethasone 6 mg/day (DXM group) versus 80 treated with weight-adjusted methylprednisolone (MTPN group).
RESULTS
Twenty-one (32.3%) patients in the DXM group died vs. 8 (10%) in the MTPN group (p-value < 0.001) and 29 (44.6%) in the DXM group required ICU admission vs. 2 (2.5%) of the MTPN group (p-value < 0.001). There were no baseline differences regarding sociodemographic characteristics with a higher mean qSOFA in the MTPN group. The hazard ratio for mortality and ICU admission adjusted for age, sex, and admission CRP was 2.189 (1.082-4.426; 95% CI) and 10.589 (2.139-48.347; 95% CI) for the DXM group, respectively, vs. MTPN group.
CONCLUSIONS
Mortality and admission to the ICU were lower in patients treated with weight-adjusted methylprednisolone compared to those treated with dexamethasone.
Topics: Humans; SARS-CoV-2; Methylprednisolone; COVID-19; Retrospective Studies; COVID-19 Drug Treatment; Dexamethasone
PubMed: 35987733
DOI: 10.1016/j.medcli.2022.06.015 -
Neurotherapeutics : the Journal of the... Mar 2023The efficacy of intravenous high-dose methylprednisolone (IVMP) in ocular myasthenia gravis (MG) has not been fully established. This study aimed to elucidate the... (Observational Study)
Observational Study
The efficacy of intravenous high-dose methylprednisolone (IVMP) in ocular myasthenia gravis (MG) has not been fully established. This study aimed to elucidate the effects of early intervention with IVMP for achieving the therapeutic targets (minimal manifestations [MM] or MM or better status with prednisolone ≤ 5 mg/day [MM5mg]) in ocular MG. In this observational study, we included a total of 1710 consecutive patients with MG enrolled in the Japan MG Registry in 2021. Of these, 204 patients with ocular MG who received immunotherapy were analyzed. The clinical course and time to first achieve MM or MM5mg after starting immunotherapy were compared between the early IVMP group (treated with IVMP within 3 months of treatment initiation) and the non-early IVMP group. Despite having greater clinical severity before immunotherapy and lower oral prednisolone doses throughout the course, the early IVMP group (n = 55) showed a higher rate of achievement of MM (P = 0.0040, log-rank test; hazard ratio 1.58, 95% confidence interval [CI] 1.13-2.20, P < 0.0001) and MM5mg (P = 0.0005, log-rank test; hazard ratio 1.78, 95% CI 1.27-2.51, P < 0.0001) compared with the non-early IVMP group (n = 149). In conclusion, an early intervention with IVMP is likely to increase the probability of achieving a better long-term outcome and reducing the total dose of corticosteroids in ocular MG.
Topics: Humans; Methylprednisolone; Treatment Outcome; Administration, Intravenous; Myasthenia Gravis; Immunotherapy
PubMed: 36607596
DOI: 10.1007/s13311-022-01335-3 -
Gastroenterology Apr 2016
Topics: Adrenal Cortex Hormones; Enteral Nutrition; Female; Hepatitis, Alcoholic; Humans; Male; Methylprednisolone
PubMed: 26924095
DOI: 10.1053/j.gastro.2016.02.061 -
BMJ Open Dec 2022Recent studies in animal models indicate that recombinant human erythropoietin (rHuEPO) is very effective in enhancing neurological recovery after spinal cord injury...
Recombinant human erythropoietin plus methylprednisolone versus methylprednisolone in treatment of acute spinal cord injury:protocol for a systematic review and meta-analysis.
INTRODUCTION
Recent studies in animal models indicate that recombinant human erythropoietin (rHuEPO) is very effective in enhancing neurological recovery after spinal cord injury (SCI). We described a protocol aimed at evaluating the efficacy of rHuEPO plus methylprednisolone (MP) compared with MP alone in improving neurological function of patients with SCI in randomised controlled trials (RCTs).
METHODS AND ANALYSIS
This study aims to explore the effect of rHuEPO combined with MP on neurological function in patients with SCI through a meta-analysis. To this end, the authors will search eight research databases for data retrieval: MEDLINE, China National Knowledge Infrastructure, Wan Fang, China Biology Medicine dis, Web of Science, PubMed, Cochrane and Embase for RCTs on SCI in any language. The primary outcome will be the American Spinal Injury Association score at the time of follow-up. The secondary outcomes will be the WHOQOL-100 instrument score, neurophysiological state and related factors. Two authors will independently search literature records, scan titles, abstracts and full texts, collect data, and assess materials for risk of bias. Stata V.14.0 will be used for statistical analysis.
ETHICS AND DISSEMINATION
This research is exempt from ethics approval because the work is carried out on published documents. We will disseminate this protocol in scientific conferences and a peer-reviewed journal.
PROSPERO REGISTRATION NUMBER
CRD42021260688.
Topics: Humans; Methylprednisolone; Systematic Reviews as Topic; Meta-Analysis as Topic; Spinal Cord Injuries; China; Research Design
PubMed: 36600375
DOI: 10.1136/bmjopen-2021-056689 -
Anatomical Record (Hoboken, N.J. : 2007) Apr 2018In addition to imperiling an individual's daily life, spinal cord injury (SCI), a catastrophic medical damage, can permanently impair an individual's body function....
In addition to imperiling an individual's daily life, spinal cord injury (SCI), a catastrophic medical damage, can permanently impair an individual's body function. Methylprednisolone (MP), a medically accepted therapeutic drug for SCI, is highly controversial for the lack of consensus on its true therapeutic effect. In recent years, curcumin has served as a potential and novel therapeutic drug in SCI. Our study was intended to investigate the precise effect of MP and curcumin in SCI. We examined the function of MP and curcumin in a SCI model rat, both in vivo and in vitro, and found that there was a momentous improvement in Basso-Beattie-Bresnahan scores in the MP-treated group when compared with Cur-treated group within 14 days. Results obtained from the histological, immunohistochemistry and ultrastructural examinations evidenced the curative effect of MP was better than curcumin before Day 14. Nonetheless, there was a significant variation in the treatment effect between the MP-treated and Cur-treated groups after 14 days. The curcumin's effectiveness was more obvious than MP after 14 days following SCI. As such, we surmise that curcumin has a better therapeutic potential than MP with a prolong treatment time in the wake of SCI. Anat Rec, 301:686-696, 2018. © 2017 Wiley Periodicals, Inc.
Topics: Animals; Curcumin; Male; Methylprednisolone; Motor Activity; Neuroprotective Agents; Rats; Rats, Sprague-Dawley; Recovery of Function; Spinal Cord; Spinal Cord Injuries
PubMed: 29150987
DOI: 10.1002/ar.23729 -
MSystems Dec 2023The SARS-CoV-2 virus infection in humans induces significant inflammatory and systemic reactions and complications of which corticosteroids like methylprednisolone have...
The SARS-CoV-2 virus infection in humans induces significant inflammatory and systemic reactions and complications of which corticosteroids like methylprednisolone have been recommended as treatment. Our understanding of the metabolic and metabolomic pathway dysregulations while using intravenous corticosteroids in COVID-19 is limited. This study will help enlighten the metabolic and metabolomic pathway dysregulations underlying high daily doses of intravenous methylprednisolone in COVID-19 patients compared to those receiving placebo. The information on key metabolites and pathways identified in this study together with the crosstalk with the inflammation and biochemistry components may be used, in the future, to leverage the use of methylprednisolone in any future pandemics from the coronavirus family.
Topics: Humans; COVID-19; Methylprednisolone; SARS-CoV-2; Administration, Intravenous; Adrenal Cortex Hormones
PubMed: 37874139
DOI: 10.1128/msystems.00726-23 -
Experimental and Clinical... May 2022Corticosteroids have an essential role as an immunosuppressive agent in transplant; because of their anti-inflammatory properties, they rarely cause an allergic...
Corticosteroids have an essential role as an immunosuppressive agent in transplant; because of their anti-inflammatory properties, they rarely cause an allergic reaction. Here, we report a liver transplant recipient who developed an allergic reaction to intravenous methylprednisolone sodium succinate. The deceased-donor orthotopic liver transplant recipient received intravenous methylprednisolone sodium succinate for induction during transplant, which was followed by another intravenous dose and oral prednisone taper. She was later treated with intravenous methylprednisolone sodium succinate taper for acute cellular rejection, which had been confirmed with a second biopsy. After admission for further treatment, she received another 1 g of intravenous methylprednisolone sodium succinate dose. About 15 to 20 minutes after receiving this dose, she presented with a new-onset urticarial rash that started on the trunk and progressed with facial edema. She continued a course of intravenous and oral dexamethasone for treatment of rejection and later was restarted on and tolerated oral prednisone. This case highlights the importance and the possibility of using dexamethasone as an alternative treatment approach for those with similar reactions to intravenous methylprednisolone sodium succinate.
Topics: Dexamethasone; Female; Humans; Hypersensitivity; Liver Transplantation; Methylprednisolone; Methylprednisolone Hemisuccinate; Prednisone; Treatment Outcome
PubMed: 32281526
DOI: 10.6002/ect.2019.0383