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Mitoxantrone-induced cardiotoxicity in patients with multiple sclerosis

Ali Hamzehloo1, Masood Etemadifar

  • 1Department of Neurology, Isfahan University of Medical Sciences, Isfahan, Iran. ali-hamzeloo@yahoo.com

Archives of Iranian Medicine
|May 3, 2006
PubMed
Abstract

Insights

Mitoxantrone is an effective treatment for multiple sclerosis, with a low risk of cardiotoxicity observed in patients over one year. This study indicates the drug is generally well-tolerated in those with progressive forms of the disease.

Area of Science:

  • Neurology
  • Cardiology
  • Pharmacology

Background:

  • Limited treatment options exist for secondary progressive and worsening relapsing-remitting multiple sclerosis (MS).
  • Mitoxantrone, an antineoplastic agent, is approved for MS treatment but carries a risk of dose-related cardiotoxicity.
  • This cardiotoxicity can restrict the clinical utility of mitoxantrone in managing MS.

Purpose of the Study:

  • To investigate the potential cardiotoxicity associated with mitoxantrone therapy in multiple sclerosis patients.
  • To evaluate cardiac function in MS patients undergoing mitoxantrone treatment over a one-year period.

Main Methods:

  • A cohort of 96 patients with worsening relapsing-remitting or secondary progressive MS was studied.
  • Cardiac assessments, including electrocardiogram and echocardiography, were performed at baseline and at 6 and 12 months.
  • Patients received mitoxantrone at a dose of 12 mg/m², with analysis focused on those receiving at least 4 doses.

Main Results:

  • No clinically significant cardiac dysfunction was observed in the 96 patients over 12 months.
  • Three patients experienced a decrease in left ventricular ejection fraction (LVEF) of <10% from baseline.
  • Three patients had an LVEF below 50%.

Conclusions:

  • Mitoxantrone (12 mg/m²) is an effective and generally well-tolerated treatment for progressive MS.
  • The risk of developing cardiotoxicity appears low in multiple sclerosis patients within one year of mitoxantrone therapy.
  • Mitoxantrone can be considered a viable option for managing specific MS subtypes, with careful cardiac monitoring.

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