Tag Archives: Cyclophosphamide

Disease Modifying Agents in the Treatment of Multiple Sclerosis

Numerous agents have been tested in multiple sclerosis and the vast majority of these have either failed to show a beneficial effect or produced undesirable side effects. In some cases, there was worsening of disease activity. Treatment strategies for multiple sclerosis over the last 16 years have undergone a profound change. Several treatment options are… Read More »

Other Off-Label Agents Used in the Treatment of RRMS

Corticosteroids Corticosteroids are considered as standard treatment for acute relapses. Corticosteroids decrease inflammation and stabilize the blood brain barrier, resulting in more rapid recovery from relapses. The standard dose is 1 g of methylprednisolone (MP) daily for 3-5 days through I/V infusion, although other regimens also have been used. Some studies have suggested that oral… Read More »

Mitoxantrone in Multiple Sclerosis

Mitoxantrone () was developed in the 1970s and is an antineoplastic agent. It is an anthracenedione derivative related to the anthracyclins doxorubicine and daunorubicine. It interacts with topoisomerase-2, stabilizes its cleavable complex with DNA, thus prevents the ligation of DNA strands, and consecutively delays the cell-cycle progression. Mitoxantrone is used to effectively treat malignancies such… Read More »

Acute Treatments

Most patients with multiple sclerosis (MS) experience relapses characterized by acute or subacute neurological dysfunction lasting days to several weeks followed by a remission with partial or complete resolution of neurological dysfunction. Attacks may occur as part of diverse demyelinating syndromes: clinically isolated syndromes [e.g., isolated optic neuritis (ON), myelitis, or brainstem syndromes], relapsing-remitting multiple… Read More »

Therapeutic Plasma Exchange

High-dose corticosteroids are the treatment of choice for acute demyelinating attack given their well-proven efficacy, as described above, and their ease of administration and cost. Therapeutic plasma exchange may be a valuable treatment for patients who fail to respond to steroids. This section focuses on the use of therapeutic plasma exchange in acute attacks of… Read More »

Acute Treatment: Cyclophosphamide

Cyclophosphamide is an alkylating agent with immunosuppressive properties and is commonly used in treatment of immune-mediated disease. The role of cyclophosphamide in multiple sclerosis has been studied extensively, and the current literature supports its use in active inflammatory demyelination. Uncontrolled data suggests that cyclophosphamide may be an effective alternative for treatment of rapidly worsening multiple… Read More »

Clinical trials of sham versus real acupuncture…

Which of the following statements describes clinical trials of sham versus real acupuncture? A. Patients with TTHs respond to both types of acupuncture. B. Patients with migraine headaches respond to both types of acupuncture. C. Acupuncture may show benefit similar to preventative medication in migraine patients. D. The psychological and physiologic benefits of acupuncture cannot… Read More »

Treatment Of Breakthrough Disease

There is consensus that therapy in relapsing-remitting multiple sclerosis (MS) in the pediatric age group should be initiated with first-line treatments approved for adult multiple sclerosis (MS), namely one of the three forms of interferon-beta or glatiramer acetate (GA). However, as in adults with multiple sclerosis (MS), the disease remains clinically or radiologically active in… Read More »

Breakthrough Therapies: Drugs Approved in Other Indications

Cyclophosphamide Cyclophosphamide is an alkylating agent that is used to treat various types of cancer as well as autoimmune diseases. The main effect of cyclophosphamide is attributed to its metabolite phosphoramide mustard, which forms DNA interstrand crosslinks in cells with low levels of aldehyde dehydrogenase, leading to cell death. For multiple sclerosis therapy, cyclophosphamide is… Read More »