A Cochrane review included 8 studies with a total of 2 145 subjects. Methylprednisolone sodium succinate has been shown to improve neurologic outcome up to one year post-injury if administered within eight hours of injury and in a dose regimen of: bolus 30 mg/kg over 15 minutes, with maintenance infusion of 5.4 mg/kg per hour infused for 23 hours. A more recent trial indicates that if methylprednisolone therapy is given for an additional 24 hours (for a total of 48 hours), additional improvement in motor neurologic function and functional status is observed. This is particularly observed if treatment is started between 3 to 8 hours after injury.
Comment: The quality of evidence is downgraded by study quality (inadequate intention-to-treat adherence).