Efficacy and safety of mitoxantrone use in primary and secondary progressive multiple sclerosis – study site experience based on the therapy of 104 patients. (3rd October 2017)

• Record Type: Journal Article
• Authors: Lasek-Bal, Anetta; Bartoszek, Karina; Steposz, Arkadiusz; Puz, Przemyslaw; Bal, Wieslaw; Kazibutowska, Zofia
• Is Part Of: International journal of neuroscience. Volume 127:Number 10(2017)
• Page Start: 859
• Page End: 863
• Publication Date: 2017-10-03
• Subjects: Multiple sclerosis -- mitoxantrone -- adverse effects; Nervous system -- Periodicals; 612.805
• DOI: 10.1080/00207454.2016.1269327
• Languages: English
• ISSNs: 0020-7454

Abstract

ABSTRACT: Mitoxantrone (MX) is used in patients with primary and secondary progressive as well as relapsing–remitting type of multiple sclerosis (PPMS, SPMS, RRMS). The objective of our project was to evaluate the efficacy and safety of MX use in patients with PPMS and SPMS. Methods: The retrospective study included 104 patients (mean age 54.2 ± 9.0), with PPMS (13.46%) and SPMS (86.54%) treated with MX. During single cycle of the MX therapy a dose of 12 mg/m 2 of body surface area was administered and next cycles every three months up to a total dose of 140 mg/m 2 were realized. Results: The course of the therapy was completed by 95 patients (91.34%) including 73 patients who received a scheduled whole dose. The average cumulative dose per patient was 75.2 mg/m 2 . Thirty-two patients reported nausea after MX administration, 20 revealed increase in the incidence of infection and 19 patients hair loss. Twenty-two patients discontinued therapy (seven patients because of the progress of disability). Independent risk factors for deterioration were: age and the form of PPMS (RR 1.56 [95% CI: 1.17–2.07] and RR 2.8 [95% CI: 1.08–7.21], respectively). Five patients revealed a asymptomatic decrease in EF value <50% or 10% in relation to the previous test. Conclusions: MX therapy enables us to stabilize the disease without causing any significant side effects in most patients with progressive disease as compared to patients with primary progressive disease with a comparable safety profile. Larger benefits of MX therapy are associated with the patients with secondary progressive disease.