Skip to main content Accessibility help
×
Home

A Controlled Trial of Mitoxantrone in Multiple Sclerosis: Serial MRI Evaluation at One Year

  • S. Bastianello (a1), C. Pozzilli (a2), F. D’Andrea (a3), E. Millefiorini (a1), M. Trojano (a1), S. Morino (a2), C. Gasperini (a2), A. Bozzao (a4), M. Gallucci (a2), C. Andreula (a5), L. Bozzao (a1), D. Gambi (a6) and M. Prencipe (a3)...

Abstract:

We present the results of a randomized double-blinded placebo controlled, multicenter trial, of low-dose mitoxantrone (MX), after one year, in 25 patients with relapsing-remitting multiple sclerosis, who had serial enhanced magnetic resonance imaging (MRI). Treatment groups were balanced for age, gender, duration of illness and neurological disability. Five of the 13 MX patients and 10 of the 12 placebo patients had exacerbations during treatment (p < 0.02). The mean change in the extended disability status scale was not significantly different between the MX and placebo treatment groups. Serial Gadolinium-DTPA enhanced MRI detected no significant difference between the MX treated and placebo groups in the mean total number of new, enlarging, or Gadolinium-DTPA enhancing lesions; there was a trend toward a reduction of new, enlarging and Gadolinium-DTPA enhancing lesions in MX patients. Despite this ameliorating effect, the results indicate that serial Gadolinium-DTPA enhanced MRI, performed over one year in a limited number of patients, could not provide conclusive evidence for a role of MX therapy in relapsing-remitting multiple sclerosis.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      A Controlled Trial of Mitoxantrone in Multiple Sclerosis: Serial MRI Evaluation at One Year
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      A Controlled Trial of Mitoxantrone in Multiple Sclerosis: Serial MRI Evaluation at One Year
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      A Controlled Trial of Mitoxantrone in Multiple Sclerosis: Serial MRI Evaluation at One Year
      Available formats
      ×

Copyright

Corresponding author

Cattedra di Neuroradiologia, Dipartimento di Scienze Neurologiche, Università di Roma “La Sapienza”, Viale dell’Università 30, 00185 Rome, Italy

References

Hide All
1.Young, IR, Hall, AS, Pallis, CA, et al. Nuclear magnetic resonance imaging of the brain in multiple sclerosis. Lancet 1981; 2: 10631066.
2.Lukes, SA, Crooks, LE, Aminoff, MJ, et al. Nuclear magnetic resonance imaging in multiple sclerosis. Ann Neurol 1983; 13: 592601.
3.Gonzales-Scarano, F, Grossman, RI, Galletta, S, Atlas, SW, Silberberg, DH.Multiple sclerosis disease activity correlates with gadolinium-enhanced magnetic resonance imaging. Ann Neurol 1987; 21:300306.
4.Grossman, RI, Braffman, BH, Brorson, JR, et al. Multiple sclerosis: serial study of gadolinium-enhanced MR imaging. Radiology 1988; 169: 117122.
5.Isaac, C, Li, DKB, Genton, M, et al. Multiple sclerosis: a serial study using MRI in relapsing patients. Neurology 1988; 38: 15111515.
6.Miller, DH, Rudge, P, Johnson, G, et al. Serial gadolinium-enhanced magnetic resonance imaging in multiple sclerosis. Brain 1988; 111:927939.
7.Willoughby, EW, Grochowski, E, Li, DKB, et al. Serial magnetic resonance scanning in multiple sclerosis: a second prospective study in relapsing patients. Ann Neurol 1989; 25: 4349.
8.Bastianello, S, Pozzilli, C, Bernardi, S, et al. Serial study of gadolinium-DTPA MRI enhancement in multiple sclerosis. Neurology 1990; 40:591595.
9.Kermode, AG, Tofts, PS, Thompson, AJ, et al. Heterogeneity of blood-brain barrier changes in multiple sclerosis: an MRI study with gadolinium-DTPA enhancement. Neurology 1990; 40: 229235.
10.Harris, JO, Frank, JA, Patronas, N, McFarlin, DE, McFarlan, HF.Serial gadolinium-enhanced magnetic resonance imaging scans in patients with early, relapsing-remitting multiple sclerosis: implications for clinical trials and natural history. Ann Neurol 1991; 29:548555.
11.McFarland, HF, Frank, JA, Albert, PS, et al. Using gadolinium-enhanced magnetic resonance imaging lesions to monitor disease activity in multiple sclerosis. Ann Neurol 1992; 32: 758766.
12.Kappos, L, Stadt, D, Ratzka, M, et al. Magnetic resonance imaging in the evaluation of treatment in multiple sclerosis. Neuroradiology 1988; 30: 299302.
13.Miller, DH, Barkhof, F, Berry, I, et al. Magnetic resonance imaging in monitoring the treatment of multiple sclerosis: concerned action guidelines. J Neurol Neurosurg Psychiatry 1991; 54: 683688.
14.Miller, DH, Thompson, AJ, Morrissey, SP, et al. High dose steroids in acute relapses of multiple sclerosis: MRI evidence for a possible mechanism of therapeutic effect. J Neurol Neurosurg Psychiatry 1992; 55: 450453.
15.Fidler, JM, Quinn De Joj, S, Smith III, FR, Gibbons, JJ.Selective immunomodulation by the antineoplastic agent mitoxantrone. Non-specific adherent suppressor cell derived from mitoxantrone treated mice. J Immunol 1986; 136: 27472754.
16.Fidler, JM, Quinn De Joj, S, Gibbons, JJ.Selective immunomodulation by the antineoplastic agent mitoxantrone. Suppression of B lymphocyte function. J Immunol 1986; 137: 727732.
17.Levine, S, Saltzam, A.Regional suppression, therapy after onset and prevention of relapses in experimental allergic encephalomyelitis by mitoxantrone. J Neuroimmunol 1986; 13: 175181.
18.Gonsette, RE, Demonty, L.Immunosuppression with mitoxantrone in multiple sclerosis: a pilot study for 2 years in 22 patients. Neurology 1990; 40 (Suppl 1): 261.
19.Kappos, L, Gold, R, Kunstler, E, et al. Mitoxantrone (MX) in the treatment of rapidly progressive multiple sclerosis: a pilot study with serial gadolinium (GD)-enhanced MRI. Neurology 1990; 40 (Suppl 1): 261.
20.Noseworthy, JH, Lee, D, Penman, M, et al. A phase II evaluation of mitoxantrone HC1 in the treatment of progressive multiple sclerosis. Neurology 1991; 41 (Suppl 1): 146.
21.Noseworthy, JH, Hopkins, MB, Vandervoort, MK, et al. An opentrial evaluation of mitoxantrone in the treatment of progressive MS. Neurology 1993; 43: 14011406.
22.Paty, D, Willoughby, E, Whithaker, J.Assessing the outcome of experimental therapies in multiple sclerosis patients. In: “Treatment of Multiple Sclerosis. Trial Design, Results and Future Perspectives.” Rudick, RA, Goodkìn, DE, eds. Springer-Verlag, Germany 1992: 4790.
23Poser, CM, Paty, DW, Scheinberg, L, et al. New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol 1983; 13:227231.
24.Kurtzke, JF.Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 1983; 33: 14421452.
25.Goodkin, DE, Ross, JS, Vanderbrug Medendorp, S, Konecsni, J, Rudick, RA.Magnetic resonance imaging lesion enlargement in multiple sclerosis. Disease-related activity, chance occurrence, or measurement artefact? Arch Neurol 1992; 49: 261263.
26.McDonald, WI.The dynamics of multiple sclerosis. J Neurol 1993; 240: 2836.
27.Kurtzke, JF.Neuroepidemiology. Part II: assessment of therapeutic trials. Ann Neurol 1986; 19: 311319.
28.Weinshenker, BG, Rice, GPA, Noseworthy, JH, et al. The natural history of multiple sclerosis: a geographically based study. 4. Applications to planning and interpretation of clinical therapeutic trials. Brain 1991; 114: 10571067.
29.Matthews, WB, Matthews, WC, eds. McAlpine’s Multiple Sclerosis, 2nd ed. Edinburgh, Churchill Livingstone, 1991.
30.Thompson, AJ, Kermode, AG, Wicks, D, et al. Major differences in the dynamics of primary and secondary progressive multiple sclerosis. Ann Neurol 1991; 29: 5362.

A Controlled Trial of Mitoxantrone in Multiple Sclerosis: Serial MRI Evaluation at One Year

  • S. Bastianello (a1), C. Pozzilli (a2), F. D’Andrea (a3), E. Millefiorini (a1), M. Trojano (a1), S. Morino (a2), C. Gasperini (a2), A. Bozzao (a4), M. Gallucci (a2), C. Andreula (a5), L. Bozzao (a1), D. Gambi (a6) and M. Prencipe (a3)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed