Summary
Twenty-one multiple sclerosis (MS) patients with a chronically progressive course were treated with a low dose of cyclophosphamide (CY). The control group consisted of 21 MS patients with a chronically progressive course who received the standard treatment (ACTH or cortisone). The control group consisted of patients who preferred the standard therapy because of its beneficial effects. In contrast, the patients of the CY group wanted to try a new therapy because the standard therapy was not effective. Thus before starting the study the progression of the disease was faster in the CY group than in the standard therapy group. As regards age, sex and degree of disability, the two groups were comparable. For 20 of the 21 patients in the CY group the degree of disability (Kurtzke scale) remained stable over 1 year; for 2 of the 20 stable patients there was even an improvement. In the standard therapy group, 7 out of 21 patients were stable over 1 year, while 14 showed progressive disability. A quantitative neurological score at the beginning and 1 year after the therapy showed a nearly identical difference between the CY group and the control group. The changes of the patients' abilities in daily-life activities (which were observed and recorded by the nurses) were similar to the Kurtzke scale data obtained by the physicians. The beneficial effect of CY in chronically progressive MS was thus highly significant (P<0.001). The side-effects of low-dose CY were fewer than those of ACTH.
Similar content being viewed by others
References
Baker GL, Kahl LE, Zee BC, Stolzer BL, Agarwal AK, Medsger TA (1987) Malignancy following treatment of rheumatoid arthritis with cyclophosphamide. Am J Med 83:1–9
Carter JL, Dawson DM, Hafler DA, Fallis RJ, Stazzone L, Hauser SL, Weiner HL (1986) Five-year experience with intensive immunosuppression in progressive multiple sclerosis using high-dose IV cyclophosphamide plus ACTH. Neurology 36 [Suppl 1]: 284
Gonsette RE, Demonty L, Delmotte P (1977) Intensive immunosuppression with cyclophosphamide in multiple sclerosis. J Neurol 1214:173–181
Hauser SL, Dawson DM, Lehrich JR, Beal MF, Kevy SV, Propper RD, Mills JA, Weiner HL (1983) Intensive immunosuppression in progressive multiple sclerosis. A randomized, three-arm study of high-dose intravenous cyclophosphamide, plasma exchange, and ACTH. N Engl J Med 308:173–180
Hommes OR, Lamers KJB, Reekers P (1980) Effect of intensive immunosuppression on the course of chronic progressive multiple sclerosis. J Neur 223:177–190
Kornhuber HH (1986) Symptomatische Therapie der Multiplen Sklerose. Kassenarzt 8:35–41
Kornhuber HH (1987) Forschung mit dem Ziel, den Patienten direkt zu helfen: Symptomatische Therapie der Multiplen Sklerose als Grundbehandlung und als Voraussetz für wirksamere Immunosuppression. In: Gemeinnützige Hertie-Stiftung (eds) Multiple Sklerose. Klinik und Grundlagenforschung. Hertie-Stiftung, Frankfurt a.M., pp 83–95
Kornhuber HH, Mauch E (1986) Immunsuppressive Cyclophosphamid-Therapie der multiplen Sklerose mit wenig Nebenwirkungen. Dtsch Med Wochenschr 111:1778
Kornhuber HH, Riebler R (1984) Mit der Multiplen Sklerose leben. Die häusliche Behandlung der MS. Schattauer, Stuttgart
Kornhuber HH, Mauch E, Petru E, Schmähl D (1987) Zum Malignitätsrisiko bei Cyclophosphamid-Therapie der multiplen Sklerose. Dtsch Med Wochenschr 112:530
McDonald WI, Halliday AM (1977) Diagnosis and classification of multiple sclerosis. Br Med Bull 33:4–8
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Mauch, E., Kornhuber, H.H., Pfrommer, U. et al. Effective treatment of chronically progressive multiple sclerosis with low-dose cyclophosphamide with minor side-effects. Eur Arch Psychiatr Neurol Sci 238, 115–117 (1989). https://doi.org/10.1007/BF00450997
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00450997