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Stabilization of rapidly worsening multiple sclerosis for 36 months in patients treated with interferon beta plus cyclophosphamide followed by interferon beta

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Abstract

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) in 10 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.

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Authors and Affiliations

  1. Department of Neurological Sciences, Via Santa Sofia 78, 95123, Catania, Italy

    Francesco Patti MD, Ester Reggio, Teresa Fiorilla, Alessandra Nicoletti & Arturo Reggio

  2. Department of Infectious Diseases, University of Catania, Italy

    Filippo Palermo

  3. Institute of Radiology, University of Catania, Italy

    Guido Politi

Authors
  1. Francesco Patti MD
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  2. Ester Reggio
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  3. Filippo Palermo
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  4. Teresa Fiorilla
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  5. Guido Politi
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  6. Alessandra Nicoletti
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  7. Arturo Reggio
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Correspondence to Francesco Patti MD.

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Patti, F., Reggio, E., Palermo, F. et al. Stabilization of rapidly worsening multiple sclerosis for 36 months in patients treated with interferon beta plus cyclophosphamide followed by interferon beta. J Neurol 251, 1502–1506 (2004). https://doi.org/10.1007/s00415-004-0581-2

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  • DOI: https://doi.org/10.1007/s00415-004-0581-2

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