Mitoxantrone treatment in multiple sclerosis: a 5‐year clinical and MRI follow‐up

  title={Mitoxantrone treatment in multiple sclerosis: a 5‐year clinical and MRI follow‐up},
  author={Carla Buttinelli and Alessandro Clemenzi and Giovanna Borriello and F G Denaro and Carlo Pozzilli and Cesare Fieschi},
  journal={European Journal of Neurology},
Mitoxantrone (MTX) is an antineoplastic agent approved for treatment of secondary progressive and rapidly worsening relapsing‐remitting multiple sclerosis (MS). We designed a longitudinal open‐label prospective study to evaluate the efficacy and toxicity of MTX over a 2‐year treatment period with a further 3‐year follow‐up. Fifty consecutive MS patients were included and received MTX intravenously (8 mg/m2 every 2 months for a total of 12 infusions). Efficacy was assessed clinically and by… 

Comparative study of mitoxantrone efficacy profile in patients with relapsing—remitting and secondary progressive multiple sclerosis

MTX should be considered as an effective therapeutic option in RR MS patients with evidence of relevant disease activity, but the potential life-threatening adverse events and the overall benefit—risk ratio must be carefully evaluated at individual patient level.

Is there a new place for mitoxantrone in the treatment of multiple sclerosis?

Mitoxantrone can be considered as a valuable therapeutic option for patients who are on the borderline of RRMS and SPMS, and suggested the beginning of conversion to SPMS.

Efficacy and safety of mitoxantrone, as an initial therapy, in multiple sclerosis: experience in an Indian tertiary care setting.

Mitoxantrone, as an initial therapy, decreases clinical exacerbations and disability progression, and has a reasonable safety profile in Indian patients with MS and NMO.

Evidence Report: The efficacy and safety of mitoxantrone (Novantrone) in the treatment of multiple sclerosis

The risk of systolic dysfunction and leukemia in patients treated with mitoxantrone is higher than suggested at the time of the previous report, although comprehensive postmarketing surveillance data are lacking.

Long-Term Risk of Leukaemia or Cardiomyopathy after Mitoxantrone Therapy for Multiple Sclerosis

It is suggested that the risk of either therapy-related acute leukaemia or cardiomyopathy after mitoxantrone therapy for multiple sclerosis is low when patients are treated within standard protocol.

Results from the 5-year, phase IV RENEW (Registry to Evaluate Novantrone Effects in Worsening Multiple Sclerosis) study

Post-hoc analyses of the risk for cardiotoxicity outcomes revealed that cumulative dose exposure is the primary risk factor associated with the risk of cardiac toxicity with Mitoxantrone.

Revision of the risk of secondary leukaemia after mitoxantrone in multiple sclerosis populations is required

The real incidence of acute myeloid leukaemia after mitoxantrone therapy in the multiple sclerosis population could be higher as evidenced by the growing number of cases reported and the necessity of re-evaluating this risk.

Optimizing Outcomes in Multiple Sclerosis – A Consensus Initiative

There was uniform consensus from this panel of MS experts that early initiation of immunomodulator therapy was beneficial for CIS patients.

Response to Mitoxantrone for Secondary Progressive Multiple Sclerosis in African Americans Compared with Whites

A retrospective evaluation of patients who had received mitoxantrone in a MS center noted unexpectedly better outcomes in six African Americans with secondary progressive multiple sclerosis compared with six white patients with similar characteristics, indicating a need to evaluate MS patients' responses to treatment by ethnicity.



Mitoxantrone in progressive multiple sclerosis: when and how to treat?

  • R. Gonsette
  • Medicine, Biology
    Journal of the Neurological Sciences
  • 2003

An open‐trial evaluation of mitoxantrone in the treatment of progressive MS

This small, open-labeled pilot study did not provide strong support for proceeding with a randomized, controlled trial of this dosage regimen of mitoxantrone in patients with progressive MS, and comparison with two historical control groups does not suggest that mitoxanrone was efficacious.

Noninvasive Assessment of Mitoxantrone Cardiotoxicity in Relapsing Remitting Multiple Sclerosis

Mitoxantrone treatment seems able to improve the clinical course of relapsing remitting multiple sclerosis patients and it does not show any cardiac toxicity in selected patients at this dosage.

Review of mitoxantrone in the treatment of multiple sclerosis

Although mitoxantrone is generally well tolerated, it is associated with a variety of potential toxicities and should probably be restricted to those patients with a suboptimal response to high-dose interferon therapy or those with rapidly progressive disease from onset.

Treatment of multiple sclerosis with mitoxantrone

It appears that mitoxantrone accelerates the disappearance of Gd-enhancing lesions and prevents the development of new ones in multiple sclerosis patients with rapid deteriorating disease profile.

Randomized placebo-controlled trial of mitoxantrone in relapsing-remitting multiple sclerosis: 24-month clinical and MRI outcome

It is suggested that mitoxantrone might be effective in reducing disease activity, both by decreasing the mean number of exacerbations and by slowing the clinical progression sustained by most patients after 1 year from the end of treatment.

A study of therapy-related acute leukaemia after mitoxantrone therapy for multiple sclerosis

The observed incidence proportion of t-AL is very low in patients who received MITO as single-agent therapy for MS, and extended follow-up of these patients and those who receive higher cumulative doses of MITO is required to define the long-term risk.

Rationale for the use of mitoxantrone in multiple sclerosis

Therapeutic effect of mitoxantrone combined with methylprednisolone in multiple sclerosis: a randomised multicentre study of active disease using MRI and clinical criteria.

In this selected group of patients with multiple sclerosis with very active disease, mitoxantrone combined with methylprednisolone was effective in improving both clinical and MRI indices of disease activity over a period of six months whereas methylpredisonsolone alone was not.