Lights and Shadows of Cyclophosphamide in the Treatment of Multiple Sclerosis
Open Access
- 1 January 2011
- journal article
- Published by Hindawi Limited in Autoimmune Diseases
- Vol. 2011, 1-14
- https://doi.org/10.4061/2011/961702
Abstract
Cyclophosphamide (cy) is an alkylating agent used to treat malignancies and immune-mediated inflammatory nonmalignant processes. It has been used as a treatment in cases of worsening multiple sclerosis (MS). Cy is currently used for patients whose disease is not controlled by beta-interferon or glatiramer acetate as well as those with rapidly worsening MS. The most commonly used regimens involve outpatient IV pulse therapy given with or without corticosteroids every 4 to 8 weeks. Side effects include nausea, headache, alopecia, pain, male and women infertility, bladder toxicity, and risk of malignancy. Previous studies suggest that cy is effective in patients in the earlier stages of disease, where inflammation predominates over degenerative processes. Given that early inflammatory events appear to correlate with later disability, a major question is whether strong anti-inflammatory drugs, such as cy, will have an impact on later degenerative changes if given early in the disease to halt inflammation.Keywords
This publication has 110 references indexed in Scilit:
- Cardiotoxicity and other adverse events associated with mitoxantrone treatment for MSNeurology, 2010
- Evidence Report: The efficacy and safety of mitoxantrone (Novantrone) in the treatment of multiple sclerosis [RETIRED]Neurology, 2010
- Mechanism of Action of Oral Fingolimod (FTY720) in Multiple SclerosisClinical Neuropharmacology, 2010
- A Placebo-Controlled Trial of Oral Cladribine for Relapsing Multiple SclerosisThe New England Journal of Medicine, 2010
- Mitoxantrone: benefits and risks in multiple sclerosis patientsNeurological Sciences, 2009
- Cyclophosphamide therapy in pediatric multiple sclerosisNeurology, 2009
- Reduction of Disease Activity and Disability With High-Dose Cyclophosphamide in Patients With Aggressive Multiple SclerosisArchives of Neurology, 2008
- The Clinical Pharmacokinetics of CladribineClinical Pharmacokinetics, 1997
- T-cell subpopulations in blood and cerebrospinal fluid of multiple sclerosis patients: Effect of cyclophosphamideClinical Immunology and Immunopathology, 1983
- Intensive Immunosuppression in Progressive Multiple SclerosisThe New England Journal of Medicine, 1983