Q. How can you tell if steroids are or aren't helping a particular flare? For example, if steroids are given very soon after the symptom onset, and if symptoms keep on getting worse for another 10 days after the last day of steroid admission, and then take a month to (more or less) go away, would you that steroids worked or not?
A. Very good question and hard to give an answer that is true in all circumstances. Generally, steroids start working within the first week if not the first few days. A person still worsening 10 days after starting steroids is probably not responding, even though we usually use the two week cutoff to define a non-responder. In the example given it is more likely that the improvement was spontaneous. After all, we do call this phase of the disease relapsing remitting for a reason.
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