Author(s): Buttinelli C, Clemenzi A, Borriello G, Denaro F, Pozzilli C,
Abstract Share this page
Abstract Mitoxantrone (MTX) is an antineoplastic agent approved for treatment of secondary progressive and rapidly worsening relapsing-remitting multiple sclerosis (MS). We designed a longitudinal open-label prospective study to evaluate the efficacy and toxicity of MTX over a 2-year treatment period with a further 3-year follow-up. Fifty consecutive MS patients were included and received MTX intravenously (8 mg/m(2) every 2 months for a total of 12 infusions). Efficacy was assessed clinically and by brain MRI performed before MTX therapy, at the end of treatment and at the end of each year of follow-up. Forty-nine patients completed the 5-year study, 44 (89.8\%) completed the MTX course, five (10.2\%) interrupted the treatment because of side effects. Fifteen (30.6\%) patients showed Expanded Disability Status Scale (EDSS) progression on treatment and nine (18.4\%) during follow-up. Seventeen (34.7\%) patients had enhancing lesions at baseline, nine (18.4\%) at the end of treatment, but none at the end of follow-up. In conclusion, we observed EDSS progression in about 1/3 of the patients during the treatment period and in 1/5 during the further 3-year follow-up period. This evidence suggests a delayed beneficial effect after MTX treatment is completed with only a minority of patients showing disability progression once the drug was suspended.
This article was published in Eur J Neurol
and referenced in Journal of Proteomics & Bioinformatics