title: Efficacy of mitoxantrone and intrathecal triamcinolone acetonide treatment in chronic progressive multiple sclerosis patients.
abstract: Treatment approaches are rare for chronic progressive patients with multiple sclerosis (MS). Objective was to evaluate the clinical benefit of repeated intrathecal application of the sustained release steroid triamcinolone acetonide or the administration of mitoxantrone (MIX) in 2 similar cohorts of chronic progressive patients with MS in an open-label fashion. Expanded Disability Status Scale scores significantly decreased after the first 6 intraspinal triamcinolone acetonide injections, which were performed every third day, and then remained stable. Walking distance significantly increased and did not reduce until the end of the 1-year-long trial period. Mitoxantrone treatment did not improve the Expanded Disability Status Scale score; however, no further significant deterioration appeared. Walking distance did not significantly decrease. Both treatment regimens were safe; the patients experienced nearly no adverse effects. Triamcinolone acetonide application provided a clinical benefit, whereas MIX administration prevented further worsening of MS symptoms. We stress that only specialists with a broad experience in intraspinal triamcinolone acetonide application and MIX administration should perform both kinds of therapy only after a careful information and risk-benefit evaluation in cooperation with the patient. Future trials will show the efficacy of combination of both treatment approaches in chronic progressive patients with MS.
authors.affiliation: Department of Neurology, St Josef Hospital, Ruhr University Bochum, Gudrunstrasse 56, 44791 Bochum, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Hellwig
authors.forename: Sebastian
authors.initials: S
authors.lastname: Schimrigk
authors.forename: Carsten
authors.initials: C
authors.lastname: Lukas
authors.forename: Volker
authors.initials: V
authors.lastname: Hoffmann
authors.forename: Nils
authors.initials: N
authors.lastname: Brune
authors.forename: Horst
authors.initials: H
authors.lastname: Przuntek
authors.forename: Thomas
authors.initials: T
authors.lastname: Müller
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D000704:Analysis of Variance; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000627:therapeutic use*; D020528:Multiple Sclerosis, Chronic Progressive / Q000188:drug therapy* / Q000503:physiopathology; D013997:Time Factors; D014222:Triamcinolone Acetonide / Q000627:therapeutic use*; D016138:Walking
chemical_list: D000700:Analgesics; D000893:Anti-Inflammatory Agents; D008942:Mitoxantrone; D014222:Triamcinolone Acetonide