Other names: Revimmune
Cyclophosphamide is a potent immunosuppressive drug that is frequently used in combination chemotherapy regimens to treat leukaemia and other forms of cancer.
Historically, cyclophosphamide has been used as a treatment for people with MS who have failed to respond to other therapies and are experiencing frequent relapses with rapid progression. Research has shown only limited benefit at best from the treatment, and the side effects mean that it is rarely used.
How cyclophosphamide is given
Cyclophosphamide can be taken orally as tablets, as an injection into a vein (intravenously), or by drip (intravenous infusion).
Side effects and contraindications
In the short-term, side effects can include hair loss, nausea, infertility, bladder irritation and risk of infection.
A French study compared tretament with cyclophosphamide with IV methylpredisolone in people with secondary progressive MS. The study was ended early due to difficulty recruiting participants. Those people who stuck with cyclophosphamide over two years were 2.7 times less likely to show disability progression than the group taking the IV steroid. However, half of those taking cyclophosphamide and a third of those taking methylprednisolone dropped out, mostly due to tolerability issues. If data from all participants was included, the trial showed no difference between treatments.
Revimmune is the brand name of a new application of cyclophosphamide administered as an ultra-high intensity, short-course intravenous infusion.
Revimmune works by eliminating the cells responsible for the immune attack that is seen in multiple sclerosis, thereby allowing the body's immune system to 'reboot'.
Revimmune is in development for a variety of autoimmune diseases, and preliminary findings suggest it holds potential as a treatment option for people with severe refractory MS - MS that is not responding to other treatments. However, further studies are necessary to determine who would most benefit from this treatment.
- Cochrane Database of Systematic Reviews 2007;(1):CD002819. Summary Cyclophosphamide for multiple sclerosis.
- CNS Neuroscience and Therapeutics 2009;15(2):118-127. Summary High-dose cyclophosphamide in the treatment of multiple sclerosis.
- Archives of Neurology 2006;63(10):1388-1393. Summary High-dose cyclophosphamide for moderate to severe refractory multiple sclerosis.
- Archives of Neurology 2008;65(8):1044-1051. Summary Reduction of disease activity and disability with high-dose cyclophosphamide in patients with aggressive multiple sclerosis.
- PLoS One 2017;12(1):e0168834. Read the full article Double-blind controlled randomized trial of cyclophosphamide versus methylprednisolone in secondary progressive multiple sclerosis.
Last updated: January 2017
Last reviewed: November 2014
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