méthylprednisolone

Methylprednisolone is a synthetic glucocorticoid used for its anti-inflammatory and immunosuppressive effects. It comes in several forms, including oral tablets and injectable preparations. Common injectable forms are methylprednisolone sodium succinate (often given intravenously for acute conditions) and methylprednisolone acetate (used for intramuscular, intra-articular, or local injections). The drug exerts its effects by binding the glucocorticoid receptor, leading to changes in gene transcription that reduce the production of inflammatory mediators, decrease leukocyte migration, and lessen tissue edema.

Indications include severe inflammatory and autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease, and severe asthma or COPD exacerbations. It is also used in dermatologic conditions, allergic reactions, and as part of organ transplantation immunosuppression regimens. In neurology and trauma care, high-dose intravenous methylprednisolone has been used for acute spinal cord injuries and for multiple sclerosis relapses, though its routine use and dosing are subject to evolving clinical guidelines due to questions about benefits and potential risks.

Adverse effects are dose- and duration-dependent and may include hyperglycemia, increased infection risk, osteoporosis, gastrointestinal ulcers, mood changes, hypertension, edema, and suppression of the hypothalamic–pituitary–adrenal axis with long-term use. Because methylprednisolone modulates immune responses, vaccine effectiveness may be reduced and live vaccines are generally avoided during therapy. Cautions include active infection, diabetes, peptic ulcer disease, psychosis, and poorly controlled hypertension, with gradual tapering recommended when discontinuing after prolonged treatment.