Contributions
Abstract: EP1604
Type: Poster Sessions
Abstract Category: Therapy - Immunomodulation/Immunosuppression
Background: Mitoxantrone (MTX) can be used in the treatment of various clinical stages of multiple sclerosis (MS). In 2000, MTX was approved by the US Food and Drug Administration for the treatment of aggressive relapsing - remitting (RRMS), secondary progressive (SPMS) and progressive-relapsing MS. MTX still remains the only agent for the treatment of both RRMS and SPMS. A difficult challenge is to indicate a subgroup of MS patients who are on the borderline of RRMS and SPMS in everyday clinical practice. The average delay in the diagnosis of SPMS is about 3 years, and the beginning of this MS variant is most likely among patients who achieved 4 points in the Expanded Disability Status Scale (EDSS). In fact, some patients with RRMS and this degree of disability have already experienced transition to SPMS.
Objective: To evaluate the efficacy of MTX on disability progression in MS patients, with particular distinction of individuals from the borderline of RRMS and SPMS.
Methods: We conduct a retrospective assessment of 100 Caucasian MS patients treated with cyclical intravenous MTX infusions at a dose of 12 mg /m². All patients underwent a clinical neurological examination during every cycle of treatment. Treatment efficacy was evaluated by comparing EDSS score between the baseline and the end of MTX therapy.
Results: The study group consist of 64 women and 36 men in mean age of 44.3 ±10.8 years. The 36 patients were distributed into RRMS, 36 into SPMS and 28 into PPMS with respect to disease course. The mean disease duration was 9,5 ±7,1 years. The mean time to transition from RRMS to SPMS was 12.1 ±6.4 years. The mean time of MTX treatment was 1,9 ±0,6 year. The mean number cycles of MTX infusion was 6,8 ±1,97 and the median total drug dose was 140 mg. We observed a decrease in the median EDSS score from 4.0 at baseline to 3.5 at the end of MTX infusion in RRMS subgroup and increase from 4.5 to 5.25 in PPMS subgroup. In the subgroup of patients with SPMS, the median EDSS score at baseline was 5.0 and remained stable during the treatment period. The median time to improve on the EDSS scale was 3 months. Among patients with confirmed disability progression ≥1.0 EDSS point, there was no RRMS patient, 8 patients had PPMS and the remaining 2 had SPMS (p=0,0004).
Conclusion: Apart from approved indications, mitoxantrone should be considered for the treatment of MS patients who are on the borderline of RRMS and SPMS.
Disclosure: Nothing to disclose.
Abstract: EP1604
Type: Poster Sessions
Abstract Category: Therapy - Immunomodulation/Immunosuppression
Background: Mitoxantrone (MTX) can be used in the treatment of various clinical stages of multiple sclerosis (MS). In 2000, MTX was approved by the US Food and Drug Administration for the treatment of aggressive relapsing - remitting (RRMS), secondary progressive (SPMS) and progressive-relapsing MS. MTX still remains the only agent for the treatment of both RRMS and SPMS. A difficult challenge is to indicate a subgroup of MS patients who are on the borderline of RRMS and SPMS in everyday clinical practice. The average delay in the diagnosis of SPMS is about 3 years, and the beginning of this MS variant is most likely among patients who achieved 4 points in the Expanded Disability Status Scale (EDSS). In fact, some patients with RRMS and this degree of disability have already experienced transition to SPMS.
Objective: To evaluate the efficacy of MTX on disability progression in MS patients, with particular distinction of individuals from the borderline of RRMS and SPMS.
Methods: We conduct a retrospective assessment of 100 Caucasian MS patients treated with cyclical intravenous MTX infusions at a dose of 12 mg /m². All patients underwent a clinical neurological examination during every cycle of treatment. Treatment efficacy was evaluated by comparing EDSS score between the baseline and the end of MTX therapy.
Results: The study group consist of 64 women and 36 men in mean age of 44.3 ±10.8 years. The 36 patients were distributed into RRMS, 36 into SPMS and 28 into PPMS with respect to disease course. The mean disease duration was 9,5 ±7,1 years. The mean time to transition from RRMS to SPMS was 12.1 ±6.4 years. The mean time of MTX treatment was 1,9 ±0,6 year. The mean number cycles of MTX infusion was 6,8 ±1,97 and the median total drug dose was 140 mg. We observed a decrease in the median EDSS score from 4.0 at baseline to 3.5 at the end of MTX infusion in RRMS subgroup and increase from 4.5 to 5.25 in PPMS subgroup. In the subgroup of patients with SPMS, the median EDSS score at baseline was 5.0 and remained stable during the treatment period. The median time to improve on the EDSS scale was 3 months. Among patients with confirmed disability progression ≥1.0 EDSS point, there was no RRMS patient, 8 patients had PPMS and the remaining 2 had SPMS (p=0,0004).
Conclusion: Apart from approved indications, mitoxantrone should be considered for the treatment of MS patients who are on the borderline of RRMS and SPMS.
Disclosure: Nothing to disclose.