论文部分内容阅读
Cyclophosphamide (CTX) is an alkylating agent related to nitrogen mustards whose anti- inflammatory and immunosuppressive effects have been utilised to treat selected cases of multiple sclerosis with a progressive and worsening course. To halt the progression of disease in patients refractory to disease modifying drugs CTX has been given, and several open- label studies have recently shown clinical benefits. In a previous study we demonstrated the effectiveness of a combination of IV monthly pulses of CTX and interferon β .(IFN- β )in10 patients with “ rapidly transitional“ form of multiple sclerosis characterised by severe and frequent attacks and rapid progression of disability. The present study reports the clinical and MRI follow- up 36 months after the discontinuation of CTX showing the maintenance of the results obtained in relapse rate (p < 0.001), EDSS (p < 0.001), T2 MRI total lesion load (p < 0.001) and T2 lesions number (p < 0.001) compared to the pre- treatment period. These encouraging findings and the absence of significant recorded side effects affirm that the association of CTX plus interferon- beta is amenable, safe and can be recommended in rapidly worsening MS patients.
Cytophosphamide (CTX) is an alkylating agent related to nitrogen mustards whose anti- inflammatory and immunosuppressive effects have been utilized to treat selected cases of multiple sclerosis with a progressive and worsening course. To halt the progression of disease in patients refractory to disease modifying drugs CTX has been, and several open-label studies have demonstrated the benefit of a combination of IV monthly pulses of CTX and interferon beta. (IFN- beta) in 10 patients with ”rapid transitional" form of multiple sclerosis characterized by severe and frequent attacks and rapid progression of disability. The present study reports the clinical and MRI follow-up 36 months after the discontinuation of CTX showing the maintenance of the results obtained in relapse rate (p <0.001) EDSS (p <0.001), T2 MRI total lesion load (p <0.001) and T2 lesions number (p <0.001) compared to the pre- treatment period. These requires findings and the absence of significant recorded side effects affirm that the association of CTX plus interferon-beta is amenable, safe and can be recommended in rapidly worsening MS patients.