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4CPS-233 Home management of acute multiple sclerosis outbreak: adaptation to coronavirus pandemic

Background and importanceAn outbreak of multiple sclerosis (MS) is defined as symptoms and neurological signs typical of demyelinating disease, with a duration of at least 24 hours It appears in all forms of MS, contributing to short and long term disability The main treatments for outbreaks are high dose steroids given intravenously or orally for 3–5 days In our clinical practice, we used oral prednisone 1400 mg for 5 days prepared in a hospital pharmacy to avoid staff attendance at health centres Aim and objectivesTo evaluate oral prednisone effectiveness as a treatment for acute MS outbreaks Material and methodsThis was a retrospective multidisciplinary study, from March to June 2020 (4 months), during the limited mobility period due to the coronavirus pandemic (SARS-CoV-2) The results of 31 patients were analysed The following data were collected: sex, age, type of MS, expanded disability status scale (EDSS), treatment at the time of the outbreak, symptoms and evolution The programmes used were: patient medical history (DIRAYA), outpatient dispensing (DOMINION) and MRI (CARESTREAM) Specialist role was: the neurologist made the clinical evaluation, the pharmacist prepared the prednisone capsules from original tablets and its dispensation, and the nurse provided patient education Results31 patients (25 women) with a mean age of 44 85 ±13 years were assessed Every patient had a diagnosis of recurrent remitting MS Treatments were: interferon beta (20), dimethyl fumarate (10) and cladribine (1) The mean EDSS was 3 The main symptoms were: paraesthesias, muscle weakness and urinary incontinence The EDSS progressed positively: 83 78% of patients evolved favourably, a subjective decrease in paraesthesia and weakness was observed and MRI showed less inflammation signs Another aspect was the comfort of the patient in carrying out this treatment at home rather than attending hospital Conclusion and relevanceThe results suggested that 1400 mg of oral prednisone administration for 5 days could be considered a safe, effective and comfortable alternative treatment for acute outbreaks of MS Multidisciplinary care is essential to obtain better clinical results References and/or acknowledgementsMorrow SA, McEwan L, Alikhani K, et al MS patients report excellent compliance with oral prednisone for acute relapses Can J Neurol Sci 2012;39:352–4 doi: 10 1017/s0317167100013500 Conflict of interestNo conflict of interest