Repeated intervals of high-dose corticosteroid: an overlooked therapy in multiple sclerosis.

The rate of conversion to multiple sclerosis is about 6% per year for five years after the first episode of optic neuritis. While the new MS agents have garnered much attention as promising agents to prevent MS relapses, an overlooked therapy is pulse high-dose corticosteroid (10 mg per kg or greater) as an intervention to delay or prevent the development of MS. Data from Optic Neuritis Treatment Trial (ONTT) and other studies underscore the need to investigate the efficacy of high-dose corticosteroid in MS.