title: Combination of cyclophosphamide and interferon-beta halts progression in patients with rapidly transitional multiple sclerosis.
abstract: The effects of combined treatment with cyclophosphamide (CTX) and interferon-beta (IFN-beta) are described in selected patients with "rapidly transitional" multiple sclerosis. This form of multiple sclerosis is extremely active with very frequent and severe attacks which produce a dramatic increase on the expanded disability status scale (EDSS). Ten patients with rapidly transitional multiple sclerosis were previously treated with interferon-beta, but none benefited by this treatment. Monthly treatment with intravenous CTX, from 500 mg/m(2) to 1500 mg/m(2) to obtain a chronic lymphocytopenia (600/mm(3) to 900/mm(3)) produced a marked and significant reduction in the number of relapses (p<0.0001), disability previously accumulated (p<0.0001), and a reduction of T2 MRI burden of lesion. This particular group of patients benefited by combining cyclophosphamide and IFN-beta. The possibility is considered of carrying out further studies to test the efficacy of the association between the two drugs for patients who are not responsive to IFN-beta or other active disease modifying therapies.
authors.affiliation: Department of Neurological Sciences, University of Catania, Via S Sofia 78, 95123 Catania, Italy. patti@mbox.unict.it
authors.forename: F
authors.initials: F
authors.lastname: Patti
authors.forename: M L
authors.initials: ML
authors.lastname: Cataldi
authors.forename: F
authors.initials: F
authors.lastname: Nicoletti
authors.forename: E
authors.initials: E
authors.lastname: Reggio
authors.forename: A
authors.initials: A
authors.lastname: Nicoletti
authors.forename: A
authors.initials: A
authors.lastname: Reggio
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000328:Adult; D017668:Age of Onset; D000704:Analysis of Variance; D016516:CD4-CD8 Ratio; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use*; D006233:Persons with Disabilities / Q000145:classification; D018450:Disease Progression; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016899:Interferon-beta / Q000627:therapeutic use*; D018655:Lymphocyte Count; D008279:Magnetic Resonance Imaging; D008297:Male; D020528:Multiple Sclerosis, Chronic Progressive / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D009460:Neurologic Examination; D012720:Severity of Illness Index; D013601:T-Lymphocytes / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D000276:Adjuvants, Immunologic; D007166:Immunosuppressive Agents; D016899:Interferon-beta; D003520:Cyclophosphamide