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Low-dose oral methotrexate treatment in chronic progressive multiple sclerosis
A Lugaresi1, C Caporale, D Farina
1Department of Oncology and Neuroscience, Gabriele d'Annunzio University, Chieti, Italy.
Summary
Low-dose oral methotrexate (LDOM) is safe for chronic progressive multiple sclerosis (CPMS) patients. LDOM demonstrated stability in 80% of patients over 18 months, with manageable side effects.
Area of Science:
- Neurology
- Immunology
- Pharmacology
Background:
- Chronic progressive multiple sclerosis (CPMS) presents significant treatment challenges.
- Existing therapies may not be effective for all CPMS patients.
Purpose of the Study:
- To evaluate the safety and efficacy of low-dose oral methotrexate (LDOM) in CPMS patients.
- To assess LDOM's impact on disease progression and patient stability.
Main Methods:
- A cohort of 20 CPMS patients, primarily with secondary progressive MS, was studied.
- Patients were followed for a mean of 23 months, with assessments including EDSS scores and MRI.
- Treatment outcomes and adverse events were systematically recorded.
Main Results:
- After one year, 15 of 20 patients remained on LDOM, with 10 showing stable disease.
- At 18 months, 8 of 12 patients were stable.
- Mild, transient liver enzyme elevations and localized herpes zoster were the main side effects.
Conclusions:
- LDOM is a safe and potentially effective treatment option for carefully selected CPMS patients.
- Its anti-inflammatory and immunomodulatory properties make it a viable add-on therapy, though long-term hepatic toxicity requires monitoring.