Evidence map›Paper›PMID 29151132›Full record

ReviewEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2019

Safety of intrathecal route: focus to methylprednisolone acetate (Depo-Medrol) use.

Joël Schlatter, David Nguyen, Michèle Zamy, Sofiane Kabiche, Jean-Eudes Fontan, Salvatore Cisternino

Abstract readReview
PubMed Publisher
In one paragraph

Review in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.7field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 16 citations in OpenAlex.

  1. Review
  2. Rethinking Corticosteroid Therapy in Pediatric Neurology.Journal of inflammation research · 2026
    Article
  3. Article
  4. Pharmacology of spinal interventions: review of agents used in spine pain procedures.Frontiers in pain research (Lausanne, Switzerland) · 2024
    Review
  5. Article
  6. The Michel Benoist and Robert Mulholland yearly European spine journal review: a survey of the "medical" articles in European spine journal, 2019.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2020
    Review
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Joël SchlatterPharmacie, Hôpital Universitaire Necker - Enfants Malades, APHP, Paris, France. joel.schlatter@aphp.fr.ORCID 0000-0002-4443-8843
David NguyenPharmacie, Hôpital Jean Verdier, APHP, Hôpitaux Universitaires de Paris-Seine-Saint-Denis (HUPSSD), Bondy, France.
Michèle ZamyPharmacovigilance, Hôpital Saint-Antoine, APHP, Hôpitaux Universitaires Est Parisien, Paris, France.
Sofiane KabichePharmacie, Hôpital Jean Verdier, APHP, Hôpitaux Universitaires de Paris-Seine-Saint-Denis (HUPSSD), Bondy, France.
Jean-Eudes FontanPharmacie, Hôpital Jean Verdier, APHP, Hôpitaux Universitaires de Paris-Seine-Saint-Denis (HUPSSD), Bondy, France.
Salvatore CisterninoPharmacie, Hôpital Universitaire Necker - Enfants Malades, APHP, Paris, France.
Assistance Publique – Hôpitaux de Paris · FRDélégation Paris 5 · FRHôpital Necker-Enfants Malades · FRSorbonne Université · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeComplications of the intrathecal route may cause potential toxicity related to the medical device and properties of the administered drug and/or excipient. A description of clinical and histological effects of polyethylene glycol and miripirium after Depo-Medrol injection, and the adverse reactions of particulate methylprednisolone acetate was conducted. The safety of the intrathecal route with excipients, label and off-label drugs is discussed.

methodsA bibliographic search in Medline, Google, and Cochrane database from 1940 to June 2016 was performed. The keywords included 'intrathecal methylprednisolone acetate', 'miripirium', 'myristyl-gamma-picolinium', 'side effects', 'intrathecal Depo-Medrol', 'polyethylene glycol', and 'intrathecal devices' used individually or in combination.

resultsAdverse reactions have been reported with this intrathecal administration route such as arachnoiditis, bladder dysfunction, headache, meningitis. Some pharmaceutical excipients have been associated with specific toxicity issues and with allergic and anaphylaxis reactions. Additives of methylprednisolone acetate formulations such as polyethylene glycol and miripirium chloride can be neurotoxic when injected intrathecally. Polyethylene glycol-an antimicrobial agent widely used in pharmaceutical drugs-has been associated with cardiovascular, hepatic, respiratory, and CNS toxicity.

conclusionsIntrathecal methylprednisolone acetate (Depo-Medrol) therapy seems not fully safe due to reported adverse events. The use of other forms of corticosteroid therapy free from excipients should be emphasized such as soluble methylprednisolone sodium succinate.

Indexed as

Anti-Inflammatory AgentsMethylprednisolone AcetateHumansInjections, SpinalAnti-Inflammatory AgentsMethylprednisolone AcetateDrug safetyIntrathecal injectionMethylprednisolone acetateOff-label

Identifiers

PMID29151132
OpenAlexW2770325926

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.