Efficacy and safety of methylprednisolone sodium succinate in acute spinal cord injury: a systematic review

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dc.contributor.author Fehlings, Michael G.
dc.contributor.author Wilson, Jefferson R.
dc.contributor.author Harrop, James S.
dc.contributor.author Kwon, Brian K.
dc.contributor.author Tetreault, Lindsay A.
dc.contributor.author Arnold, Paul M.
dc.contributor.author Singh, Jeffrey M.
dc.contributor.author Hawryluk, Gregory
dc.contributor.author Dettori, Joseph R.
dc.date.accessioned 2018-03-09T12:55:06Z
dc.date.available 2018-03-09T12:55:06Z
dc.date.issued 2017
dc.identifier.citation Fehlings, M. G., Wilson, J. R., Harrop, J. S., Kwon, B. K., Tetreault, L. A., Arnold, P. M., Singh, J. M., Hawryluk, G. and Dettori, J. R. (2017) 'Efficacy and safety of methylprednisolone sodium succinate in acute spinal cord injury: a systematic review', Global Spine Journal, 7(3S), pp. 116-137. doi: 10.1177/2192568217706366 en
dc.identifier.volume 7
dc.identifier.issued 3S
dc.identifier.startpage 116
dc.identifier.endpage 137
dc.identifier.issn 2192-5682
dc.identifier.uri http://hdl.handle.net/10468/5594
dc.identifier.doi 10.1177/2192568217706366
dc.description.abstract Study Design: Systematic review and meta-analysis. Objective: The objective of this study was to conduct a systematic review to assess the comparative effectiveness and safety of high-dose methylprednisolone sodium succinate (MPSS) versus no pharmacological treatment in patients with traumatic spinal cord injury (SCI). Methods: A systematic search was performed in PubMed and the Cochrane Collaboration Library for literature published between January 1956 and June 17, 2015. Included studies ere critically appraised, and Grades of Recommendation Assessment, Development and Evaluation methods were used to determine the overall quality of evidence for primary outcomes. Previous systematic reviews on this topic were collated and evaluated using the Assessment of Multiple Systematic Reviews scoring system. Results: The search yielded 723 citations, 13 of which satisfied inclusion criteria. Among these, 6 were primary research articles and 7 were previous systematic reviews. Based on the included research articles, there was moderate evidence that the 24-hour NASCIS II (National Acute Spinal Cord Injury Studies) MPSS regimen has no impact on long-term neurological recovery when all postinjury time points are considered. However, there is also moderate evidence that subjects receiving the same MPSS regimen within 8 hours of injury achieve an additional 3.2 points (95% confidence interval = 0.10 to 6.33; P = .04) of motor recovery compared with patients receiving placebo or no treatment. Conclusion: Although safe to administer, a 24-hour NASCIS II MPSS regimen, when all postinjury time points are considered, has no impact on indices of long-term neurological recovery. When commenced within 8 hours of injury, however, a high-dose 24-hour regimen of MPSS confers a small positive benefit on long-term motor recovery and should be considered a treatment option for patients with SCI. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Sage Publications en
dc.relation.uri http://journals.sagepub.com/doi/10.1177/2192568217706366
dc.rights © 2017, the Authors. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/licenses/by-nc-nd/4.0/ ) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). en
dc.rights.uri http://www.creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject Methylprednisolone sodium succinate en
dc.subject MPSS en
dc.subject Spinal cord injury en
dc.subject Systematic review en
dc.subject Traumatic spinal cord injury en
dc.title Efficacy and safety of methylprednisolone sodium succinate in acute spinal cord injury: a systematic review en
dc.type Review en
dc.internal.authorcontactother Lindsay A. Tetreault, Medicine, University College Cork, Cork, Ireland. +353-21-490-3000 Email: 116100017@umail.ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder AOSpine
dc.contributor.funder American Association of Neurological Surgeons
dc.contributor.funder Congress of Neurological Surgeons
dc.contributor.funder Gerald and Tootsie Halbert Chair in Neural Repair and Regeneration
dc.contributor.funder DeZwirek Family Foundation
dc.contributor.funder Krembil Foundation
dc.description.status Peer reviewed en
dc.identifier.journaltitle Global Spine Journal en


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© 2017, the Authors. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/licenses/by-nc-nd/4.0/ ) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). Except where otherwise noted, this item's license is described as © 2017, the Authors. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/licenses/by-nc-nd/4.0/ ) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
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