Short course of mitoxantrone shows promise as therapy for MS
A treatment regimen involving a short course of mitoxantrone and maintenance therapy with glatiramer acetate appears to be effective in patients with active relapsing remitting multiple sclerosis (MS), say UK researchers.
Jason Ramtahal and colleagues from the Walton Centre for Neurology and
Neurosurgery in Liverpool treated 27 consecutive patients with mitoxantrone
and glatiramer and observed a sustained 90 per cent reduction in annualised
relapse rates (P<0.001). After a mean follow up of 36 months, clinical
relapses had occurred in two patients. The combination, say the researchers,
was well tolerated and not associated with adverse events other than
those known to be related to mitoxantrone
(therapy-related acute leukaemia, transient amenorrhoea and leucopenia).
The researchers explain that treatment protocols are needed to minimise
exposure to mitoxantrone because of the drug’s potential to cause
cumulative cardiotoxicity. They devised the protocol (five pulses of
mitoxantrone at months 0, 1, 2, 5 and 8, with daily glatiramer 20mg being
introduced between the third and fourth pulses of mitoxantrone), following
disappointing results with interferon beta used in a number of patients
whose disease had stabilised on mitoxantrone.
The researchers conclude: “The profound and apparently sustained
effect on relapse activity seen with this novel combination appears greater
than that seen with either agent alone.” The study is due to be
published in the Journal of Neurology
MS audit Few primary care trusts
are monitoring delivery of services for multiple sclerosis (MS) patients
in line with National Institute
for Health and Clinical
Excellence recommendations, the authors of a recent audit suggest. The report,
published by the Multiple Sclerosis Trust and the Royal College of Physicians,
says that NICE’s multiple sclerosis guideline is being used by PCTs when
commissioning services, but not when monitoring them. The authors say that the
low response to the audit (32 per cent of PCTs from the six strategic health
authorities selected) suggests that services for people with MS are given low
priority. |
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