Induction Therapy with Mitoxantrone Reduces Relapses in Multiple Sclerosis
DENVER, CO -- April 17, 2002 -- Used in induction therapy, mitoxantrone dramatically decreases disease activity in multiple sclerosis (MS) patients for at least four years, according to a study presented at the Annual Meeting of the American Academy of Neurology (AAN) in Denver, Colorado.
Mitoxantrone is a chemical routinely used to fight breast cancer, leukemia and malignant lymphoma.
Frequently used against cancers, induction therapy is designed to wipe out abnormal cells and allow for the re-growth of normal cells.
Mitoxantrone for the treatment of MS has recently been approved by the U.S. Food and Drug Administration. It has been used to treat MS in France for more than a decade. Researchers from CHU Pontchaillou of Rennes, France, have demonstrated that mitoxantrone induction therapy for relapsing-remitting MS (RRMS) patients has produced dramatic results in disease activity.
Over the past ten years, 100 worsening RRMS patients were given initial mitoxantrone induction therapy for six months, with mitoxantrone combined with methylprednisolone administered intravenously on a monthly schedule. The annual relapse rate decreased significantly from 3.20 during the 12 months preceding mitoxantrone onset to 0.30 during the first year following induction onset, corresponding to a reduction of nearly 90 percent that was maintained for more than five years. The percentage of relapse-free patients was 76 percent at one year of follow-up, and was maintained at 64 percent, 45 percent, and 43 percent at years two, three and four, respectively, with a median time to the first relapse of 2.8 years.
"The clinical benefit and reduction of disease activity supports our belief that mitoxantrone, as administered in this study, may be an effective induction treatment before initiating other long-term disease modifying therapies for worsening relapsing-remitting MS patients," commented study author Emmanuelle Le Page, MD.
SOURCE: American Academy of Neurology
Therapy-related acute myeloblastic leukemia after mitoxantrone treatment in a patient with MS.
Brassat D, Recher C, Waubant E, Le Page E, Rigal-Huguet F, Laurent G, Edan G, Clanet M.
Departments of Neurology (Drs. Brassat and Clanet) and Haematology (Drs. Recher, Rigal-Huguet and Laurent) Hopital Purpan, Toulouse University Medical Center, Toulouse.
The authors report a patient with severe secondary progressive MS who responded to mitoxantrone but developed a fatal acute myeloblastic leukemia 15 months after completion of mitoxantrone therapy. Therapy-related acute leukemia (TRAL) in relation with mitoxantrone is rare; this patient was the first case among a cohort of 802 French MS patients treated with mitoxantrone. Nevertheless, this case stresses the need to further evaluate the long-term risk of TRAL in patients with MS who receive mitoxantrone.
PMID: 12297591 [PubMed - in process]