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Related Experiment Videos

Cyclophosphamide for multiple sclerosis.

L La Mantia1, C Milanese, N Mascoli

  • 1Istituto Nazionale Neurologico C. Besta, MS Group, Via Celoria, 11, Milano, ITALY, 20133. msgroup@istituto-besta.it

The Cochrane Database of Systematic Reviews
|January 27, 2007
PubMed
Summary
This summary is machine-generated.

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Cyclophosphamide (CFX) did not prevent long-term disability progression in progressive multiple sclerosis (MS). While some short-term benefits were observed, adverse events like sepsis and amenorrhea were frequent, suggesting CFX is not suitable for clinical practice.

Area of Science:

  • Neuroimmunology
  • Clinical Neurology
  • Pharmacology

Background:

  • Multiple sclerosis (MS) is an autoimmune disease affecting the central nervous system.
  • Cyclophosphamide (CFX), an immunosuppressive agent, has shown controversial efficacy in MS treatment.
  • This systematic review evaluates CFX's effectiveness in slowing the progression of MS.

Purpose of the Study:

  • To determine if cyclophosphamide (CFX) can slow disability progression in patients with progressive multiple sclerosis (MS).
  • To systematically review randomized controlled trials (RCTs) assessing CFX efficacy in progressive MS.

Main Methods:

  • Systematic literature search of multiple databases (Cochrane MS Group, CENTRAL, MEDLINE, EMBASE) and contact with researchers.
  • Inclusion of randomized controlled trials (RCTs) of CFX (alone or with ACTH/steroids) versus placebo/no treatment in progressive MS.

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  • Independent data extraction and quality assessment by two reviewers.

    • Main Results:

    • Four RCTs involving 152 participants were analyzed.
    • CFX did not prevent long-term (12-24 months) disability progression in progressive MS.
    • Short-term disability improvement favored CFX at 12 and 18 months, but worsened by 24 months; sepsis and amenorrhea were common side effects.

    Conclusions:

    • The intensive schedule of CFX does not support its use in clinical practice for progressive MS.
    • The review could not fully achieve all specified objectives due to limited data.
    • Further research may be needed to clarify the role, if any, of CFX in specific MS contexts.