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Mitoxantrone treatment in patients with early relapsing-remitting multiple sclerosis

E Cocco1, P Marchi, C Sardu

  • 1Centro Sclerosi Multipla, Dipartimento di. Scienze Cardiovascolari e Neurologiche, University of Cagliari, Italy.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|May 1, 2007
PubMed

Insights

Mitoxantrone (MITOX) significantly reduced relapse rates and improved disability scores in patients with highly active relapsing-remitting multiple sclerosis. Most patients maintained stable MRI scans post-treatment, suggesting MITOX is a viable option for active early MS.

Area of Science:

  • Neurology
  • Immunology
  • Radiology

Background:

  • Highly active relapsing-remitting multiple sclerosis (MS) requires effective early intervention.
  • Mitoxantrone (MITOX) is an immunomodulatory agent with potential in MS treatment.
  • Assessing long-term clinical and MRI outcomes of MITOX in early MS is crucial.

Purpose of the Study:

  • To evaluate the clinical and MRI effects of mitoxantrone in patients with highly active early relapsing-remitting MS.
  • To analyze changes in Expanded Disability Status Scale (EDSS) and annualized relapse rate (ARR).
  • To assess the impact of MITOX on MRI lesion activity (T2, T1, and Gd-enhancing lesions).

Main Methods:

  • A cohort of 45 patients with highly active early MS received mitoxantrone.
  • Clinical data (EDSS, ARR) and brain MRI (T2, T1, Gd-enhancing lesions) were collected at baseline, end of treatment, and during follow-up (mean 3.6 years clinical, 1.8 years MRI).
  • Parametric and non-parametric statistical tests were used for analysis.

Main Results:

  • Significant reductions in ARR (P < 0.0001) and improvements in EDSS (P < 0.0001) were observed.
  • At treatment end, 53% had no increase in T2 lesions and 73% had no new T1 lesions.
  • At follow-up, 91% of patients showed stable MRI and were active-scan free.

Conclusions:

  • Mitoxantrone demonstrated significant clinical benefits, including reduced relapse rates and improved disability.
  • The majority of patients achieved stable MRI outcomes, indicating sustained disease control.
  • Despite potential risks like leukemia in one patient, MITOX can be considered for selected early, highly active MS cases.

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