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Related Experiment Videos

Cyclophosphamide in chronic progressive multiple sclerosis. Maintenance vs nonmaintenance therapy.

D E Goodkin, S Plencner, J Palmer-Saxerud

    Archives of Neurology
    |August 1, 1987
    PubMed
    Summary

    High-dose intravenous cyclophosphamide (IVC) stabilized multiple sclerosis (MS) in 59% of patients compared to 17% in controls. IVC showed promise for chronic progressive MS, though maintenance therapy and side effects require further study.

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    Area of Science:

    • Neuroimmunology
    • Clinical Neurology
    • Pharmacology

    Background:

    • Chronic progressive multiple sclerosis (MS) presents significant management challenges.
    • Intravenous cyclophosphamide (IVC) is an immunosuppressive agent with potential therapeutic applications in MS.

    Purpose of the Study:

    • To evaluate the efficacy and safety of high-dose IVC in treating chronic progressive MS.
    • To compare induction therapy with and without maintenance therapy.
    • To assess the impact of inpatient versus outpatient administration.

    Main Methods:

    • Twenty-seven patients with chronic progressive MS received high-dose IVC induction.
    • Patients were randomized to alternate-month maintenance or no maintenance therapy.
    • Outcomes were compared with 24 nonrandomized control patients at 12, 18, and 24 months.

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    Main Results:

    • Fifty-nine percent of IVC-treated patients were stable at 12 months versus 17% of controls (p < 0.05).
    • This significant difference persisted at 18 and 24 months.
    • Maintenance therapy showed a non-significant trend favoring stability; inpatient vs. outpatient induction had no impact.

    Conclusions:

    • High-dose IVC induction therapy demonstrates significant efficacy in stabilizing chronic progressive MS.
    • While a trend favored maintenance, its statistical significance was not achieved.
    • Nausea and vomiting were significant barriers to ongoing maintenance therapy.