Open AccessUse of glucocorticoids in acute spinal cord injuries: a last decade analysis
Author(s) -
Guilherme Dantas Campos Pinto,
Gabriela Arcoverde Wanderley,
Gustavo Sales Santa Cruz,
Luís Eduardo Nobrega Nogueira Alves,
Wagner Gonçalves Horta
Publication year - 2021
Language(s) - English
Resource type - Conference proceedings
DOI - 10.5327/1516-3180.057
Subject(s) - medicine , meta analysis , randomized controlled trial , methylprednisolone , drug trial , spinal cord injury , spinal cord , clinical trial , psychiatry
The early use of methylprednisolone (MP) pulse represents the only treatment suggested to stop neurological outcomes in non-operable acute spinal cord injuries (ASCI). The protocol of the drug use dates from the 1990s and results of the NASCIS 2 randomized clinical trial. However, such conduct is still an issue for discussion, due to limited evidence. Objective: To compare the results of the main studies about the use of MP in the ASCI published in the last decade. Methods: This is a narrative review of the use of MP in the ASCI. A search was carried out using the keywords “acute spinal cord injury” and “methylprednisolone” on PubMed and Cochrane, in April 2021. Indexed meta- analysis from 2011 to 2020 were used as filters. All studies (3) were selected for analysis and comparison of their results. Results: Cochrane meta-analysis, in 2012 concluded that MP administration results in an improvement of the neurological outcome and presents good safety margin. Although it agrees with the drug harmless, a Canadian study in 2017 pointed out the MP offers a poor motor function benefit in the long term. Recently, in 2019, a meta-analysis from the American Academy of Neurology, did not recommend the use of MP in the ASCI, because of the lack of benefit in neurological function and increased occurrence of complications after the adoption of the therapy. Conclusion: Data from the last ten years of analysis demonstrates a progressive decrease in the evidence in favor of the use of MP in the ASCI.