Comparison of Mitoxantrone versus Cyclophosphamide Treatment in Patients with Secondary Progressive Multiple Sclerosis

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Comparison of Mitoxantrone versus Cyclophosphamide Treatment in Patients with Secondary Progressive Multiple Sclerosis

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Objective: Mitoxantrone (Mtx) and cyclophosphamide (Cyc) have successfully been used in highly aggressive multiple sclerosis (MS) patients. This study aims to compare the efficacy of these drugs in patients with secondary progressive MS (pwSPMS). Method: Clinical data of pwSPMS treated with either Mtx or Cyc were collected retrospectively. The EDSS scores before, during, and after the drug was determined. The efficacy of the drug was evaluated according to the EDSS change after the completion of therapy. The variations in clinical benefit between the two groups were investigated, as well as the factors that influenced them. Results: Fifty-nine SPMS patients (29 Mtx, 30 Cyc) were included in our study. Mean treatment periods were 19.5±9.9 months for Mtx and 9.1±4.1 months for the Cyc group. Mean EDSS in Mtx and Cyc groups at the first dose were 6.2±0.7 and 6.3±0.8, respectively (p=0.42). The percentage of patients who benefited from treatment was 41.6% in the Mtx group and 43.0% in the Cyc group (p=0.54). However, Mtx was more effective in patients with younger age of disease onset (p=0.01). Conclusion: Immunosuppression with intravenous Mtx and Cyc may equally prevent progression in patients with SPMS. Additionally, Mtx may be more beneficial in MS patients with earlier disease onset.

Anahtar Kelimeler

• Mitoxantrone
• Cyclophosphamide;
• Multiple Sclerosis
• Chronic Progressive; Alkylating Agents; Topoisomerase II Inhibitors

Kaynakça

1. 1. Thompson AJ, Baranzini SE, Geurts J, et al. Multiplesclerosis. The Lancet. 2018;391:1622-36.
2. 2.Filippi M, Preziosa P, Langdon D, et al. IdentifyingProgression in Multiple Sclerosis: New Perspectives.Ann Neurol. 2020;88:438-52.
3. 3.Kavaliunas A, Manouchehrinia A, Stawiarz L, et al.Importance of early treatment initiation in theclinical course of multiple sclerosis. MultipleSclerosis. 2017;23:1233-40.