Cyclophosphamide as second-line therapy in multiple sclerosis: benefits and risks.
Neurol Sci
; 30 Suppl 2: S171-3, 2009 Oct.
Article
em En
| MEDLINE
| ID: mdl-19882369
ABSTRACT
Cyclophosphamide (Cy) is an alkylating agent used over the past 40 years to halt rapidly progressive forms of multiple sclerosis (MS). High doses of Cy produce marked immunosuppression and an anti-inflammatory immune deviation. Cy is most effective in young patients, with very active MS (frequent relapses, rapid accumulation of disability, and gad+ lesions on brain MRI). Monthly intravenous pulses of Cy for 1 year, followed by bimonthly pulses for the second year are a well-tolerated protocol in MS. Most side effects (mild alopecia, nausea and vomiting, and cystitis) are transient, dose dependent, and reversible. Permanent amenorrhoea and bladder cancer have rarely been described. As second-line therapy, Cy can be used in non-responders to IFN-beta or glatiramer acetate. As induction therapy, a short course (6-12 months) of Cy can precede immunomodulatory drugs in selected patients with an aggressive MS onset.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ciclofosfamida
/
Alquilantes
/
Esclerose Múltipla
Tipo de estudo:
Etiology_studies
/
Guideline
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Neurol Sci
Assunto da revista:
NEUROLOGIA
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Itália