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

dc.contributor.authorFehlings, Michael G.
dc.contributor.authorWilson, Jefferson R.
dc.contributor.authorHarrop, James S.
dc.contributor.authorKwon, Brian K.
dc.contributor.authorTetreault, Lindsay A.
dc.contributor.authorArnold, Paul M.
dc.contributor.authorSingh, Jeffrey M.
dc.contributor.authorHawryluk, Gregory
dc.contributor.authorDettori, Joseph R.
dc.contributor.funderAmerican Association of Neurological Surgeons
dc.contributor.funderCongress of Neurological Surgeons
dc.contributor.funderGerald and Tootsie Halbert Chair in Neural Repair and Regeneration
dc.contributor.funderDeZwirek Family Foundation
dc.contributor.funderKrembil Foundation
dc.description.abstractStudy 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.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.identifier.citationFehlings, 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: 10.1177/2192568217706366en
dc.identifier.journaltitleGlobal Spine Journalen
dc.publisherSage Publicationsen
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.subjectMethylprednisolone sodium succinateen
dc.subjectSpinal cord injuryen
dc.subjectSystematic reviewen
dc.subjectTraumatic spinal cord injuryen
dc.titleEfficacy and safety of methylprednisolone sodium succinate in acute spinal cord injury: a systematic reviewen
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