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Long-term experience with induction treatment regimens in multiple sclerosis.
J Neurol Sci 2009; 277 Suppl 1:S46-9JN

Abstract

The concept of induction treatment followed by a long-term maintenance treatment has attracted much attention for the treatment of multiple sclerosis. In particular, the combination of induction therapy with mitoxantrone followed by maintenance therapy with an immunomodulatory treatment such as an interferon-beta or glatiramer acetate is of particular interest. This approach is suitable for patients with particularly aggressive disease, characterised by frequent early relapses with incomplete recovery and multiple gadolinium-enhancing T1 lesions on magnetic resonance imaging. Long-term studies show that a short (six-month) course of mitoxantrone provides a rapid reduction in disease activity and sustained disease control up to at least five years of maintenance therapy with an immunomodulatory treatment. Clinical benefit seems to be greatest when patients with aggressive disease are treated early. Randomised studies have demonstrated that induction with mitoxantrone followed by maintenance treatment provides superior disease control to monotherapy with an interferon-beta. With the treatment protocol recommended for use in France (six monthly administrations of mitoxantrone iv at a cumulative dose of 72 mg/m(2)), mitoxantrone is generally well-tolerated. These findings encourage the use of such induction regimens in patients who present early signs of aggressive disease.

Authors+Show Affiliations

Département de neurologie, Hôopital Pontchaillou, Rennes, France. emmanuelle.lepage@chu-rennes.frNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

19200867

Citation

Le Page, Emmanuelle, and Gilles Edan. "Long-term Experience With Induction Treatment Regimens in Multiple Sclerosis." Journal of the Neurological Sciences, vol. 277 Suppl 1, 2009, pp. S46-9.
Le Page E, Edan G. Long-term experience with induction treatment regimens in multiple sclerosis. J Neurol Sci. 2009;277 Suppl 1:S46-9.
Le Page, E., & Edan, G. (2009). Long-term experience with induction treatment regimens in multiple sclerosis. Journal of the Neurological Sciences, 277 Suppl 1, pp. S46-9. doi:10.1016/S0022-510X(09)70013-9.
Le Page E, Edan G. Long-term Experience With Induction Treatment Regimens in Multiple Sclerosis. J Neurol Sci. 2009 Feb 1;277 Suppl 1:S46-9. PubMed PMID: 19200867.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term experience with induction treatment regimens in multiple sclerosis. AU - Le Page,Emmanuelle, AU - Edan,Gilles, PY - 2009/2/10/entrez PY - 2009/2/10/pubmed PY - 2009/7/8/medline SP - S46 EP - 9 JF - Journal of the neurological sciences JO - J. Neurol. Sci. VL - 277 Suppl 1 N2 - The concept of induction treatment followed by a long-term maintenance treatment has attracted much attention for the treatment of multiple sclerosis. In particular, the combination of induction therapy with mitoxantrone followed by maintenance therapy with an immunomodulatory treatment such as an interferon-beta or glatiramer acetate is of particular interest. This approach is suitable for patients with particularly aggressive disease, characterised by frequent early relapses with incomplete recovery and multiple gadolinium-enhancing T1 lesions on magnetic resonance imaging. Long-term studies show that a short (six-month) course of mitoxantrone provides a rapid reduction in disease activity and sustained disease control up to at least five years of maintenance therapy with an immunomodulatory treatment. Clinical benefit seems to be greatest when patients with aggressive disease are treated early. Randomised studies have demonstrated that induction with mitoxantrone followed by maintenance treatment provides superior disease control to monotherapy with an interferon-beta. With the treatment protocol recommended for use in France (six monthly administrations of mitoxantrone iv at a cumulative dose of 72 mg/m(2)), mitoxantrone is generally well-tolerated. These findings encourage the use of such induction regimens in patients who present early signs of aggressive disease. SN - 0022-510X UR - https://www.unboundmedicine.com/medline/citation/19200867/Long_term_experience_with_induction_treatment_regimens_in_multiple_sclerosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-510X(09)70013-9 DB - PRIME DP - Unbound Medicine ER -