Preliminary clinical results indicate that the
cytostatic agent mitoxantrone is an effective and very tolerable substance for treating
multiple sclerosis (ms). Our own experience, added to the findings of other pilot studies, seems to indicate that
disease progression can be slowed in a majority of patients with rapidly progressive ms.
Mitoxantrone is mainly excreted by the hepato-biliary pathways and therefore it can be used in patients with
renal insufficiency or chronic
cystopyelitis, a frequently occurring condition in ms. The side effects observed in our therapeutic scheme which could be attributed to
mitoxantrone were tolerable. Mild gastrointestinal complaints were occasionally reported and
vomiting was very rare. A carcinogenic effect from
mitoxantrone has not been reported. A decrease in the leucocyte count is to be expected 6-15 days following treatment administration. Potential
cardiotoxicity represents the primary long term adverse reaction and thus patients with cardiovascular risk factors should not be treated with
mitoxantrone. Once a cumulative dosage of 140 mg/m2 is reached cardiac function tests, including echocardiography with measurement of the left ventricular ejection fraction, should be routinely carried out preceding each treatment administration in all patients.
Mitoxantrone is currently not licensed for use in patients with ms and therefore should be restricted to patients with rapid
disease progression where other generally accepted treatment modalities have failed.