Comparative clinical trial of cyclosporine in multiple sclerosis: the pros

In a German multicenter study (L. Kappos, U. Patzold, D. Dommasch, S. Poser, et al) the effects of cyclosporine A on multiple sclerosis (MS) were compared to those of azathioprine in a blind controlled trial of 194 patients. At the time of this report, each of the patients had completed at least 2 years of treatment, and several had been treated for 3 years. Included in the study were patients with MS diagnosed according to Schumacher criteria, who had one or more cerebrospinal fluid changes typical for this disease. We admitted only patients between the ages 18 and 50, who had not had an acute relapse within 10 weeks of entrance to the study and whose Kurtzke Disability Status Scale (DSS) rating was below 6.5. Our findings indicate that the drug was well tolerated; however, elevated serum creatinine values and elevated blood pressures (not always related to each other) were the main side effects, despite a meticulous monitoring of cyclosporine A blood levels. There was only a minor overall clinical deterioration in both groups.