MS research update - 25 September 2009
- Mitoxantrone reduces MS relapses and disability
- Study administers female sex hormones to prevent relapses after childbirth
- Sativex fails to show evidence of effects on spasticity
Mitoxantrone reduces MS relapses and disability
Though not licensed for the treatment of multiple sclerosis in the UK, the chemotherapy drug mitoxantrone has been used in some MS specialist centres across the UK to treat more aggressive forms of relapsing remitting MS in recent years. This Indian study reports on the effects of mitoxantrone in a group of 23 people with MS. 17 people completed one year of mitoxantrone and experienced significantly less frequent relapses and an improved level of disability. Ten completed two years of mitoxantrone treatment and saw further improvements in the rate of relapses and level of disability. The side effects of the drug led three people to stop treatment - two cases of severe leucopenia - a significant decrease in white blood cells - and one of cardiotoxicity - damage to the heart muscle. The authors conclude that mitoxantrone, as an initial therapy, reduces relapses and disability progression and has a reasonably safe side effect profile.
Singhal BS, Geeta S, Hundalani SG, et al.
Efficacy and safety of mitoxantrone, as an initial therapy, in multiple sclerosis: Experience of an Indian tertiary care setting.
Neurology India 2009;57(4):418-423.
Medline abstract
Study administers female sex hormones to prevent relapses after childbirth
Research suggests that there is a two-thirds reduction in the frequency of relapses experienced by women with MS during the third trimester of pregnancy but a two-thirds increase in frequency of relapses during the first three months after childbirth compared with their previous relapse rates. These changes correlate with changes in the levels of female sex hormones present in the body, which suggests that they must somehow modify the inflammatory response that accounts for the occurrence of relapses in MS. This article describes the methods and aims of a study currently underway to investigate the effects of administering high doses of the sex hormone progestin in combination with estradiol, another female sex hormone, in women with MS for three months commencing immediately after childbirth. The POPART'MUS (prevention of post partum relapses with progestin and estradiol in multiple sclerosis) study has enrolled 126 women to date. If the treatment regime proves effective, it has significant implications for the recommended treatment options for women with MS following childbirth.
Vukusic S, Ionescu I, El-etr M, et al.
The prevention of post-partum relapses with progestin and estradiol in multiple sclerosis (POPART'MUS) trial: rationale, objectives and state of advancement.
Journal of Neurological Sciences 2009. [Epub ahead of print].
Medline abstract
Sativex fails to show evidence of effects on spasticity
Sativex is an unlicensed cannabis-based medicine that is taken as a mouth spray. Recent trials of Sativex have demonstrated positive effects on pain and spasticity for people with MS. In view of these positive results, the drug manufacturer has recently applied for a UK license. This Italian study however, reports on the lack of effect of Sativex in 20 people with MS in terms of their spasticity as demonstrated upon physical examination and in terms of laboratory markers associated with spasticity (changes that are detected by the examination of samples in a laboratory). Furthermore, there was no evidence of its effects on the central nervous system processes on which cannabis-based medicines are thought to work.
Centonze D, Mori F, Koch G, et al.
Lack of effect of cannabis-based treatment on clinical and laboratory measure in multiple sclerosis.
Neurological Sciences 2009 [Epub ahead of print].
Medline abstract