Comparison of Mitoxantrone versus Cyclophosphamide Treatment in  Patients with Secondary Progressive Multiple Sclerosis

Kürtüncü, Murat; Cakar, Arman; AKCAY, halil ibrahim; GÜNDÜZ, TUNCAY; Ozcan, Gonca; Ozdag Acarli, Ayse Nur; ERAKSOY, MEFKURE

doi:10.5798/dicletip.1086113

Comparison of Mitoxantrone versus Cyclophosphamide Treatment in Patients with Secondary Progressive Multiple Sclerosis

Tuncay GÜNDÜZ, (İstanbul Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, İstanbul, Türkiye)

Gonca Ozcan, (İstanbul Üniversitesi, Tıp Fakültesi, İstanbul, Türkiye)

Arman ÇAKAR, (İstanbul Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, İstanbul, Türkiye)

halil ibrahim AKCAY, (İstanbul Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, İstanbul, Türkiye)

Ayşe Nur ÖZDAĞ ACARLI, (İstanbul Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, İstanbul, Türkiye)

Mefküre ERAKSOY, (İstanbul Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, İstanbul, Türkiye)

Murat KÜRTÜNCÜ (İstanbul Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, İstanbul, Türkiye)

Dicle Tıp Dergisi

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Yıl: 2022 Cilt: 49 Sayı: 1 Sayfa Aralığı: 29 - 35 Metin Dili: İngilizce DOI: 10.5798/dicletip.1086113 İndeks Tarihi: 21-09-2022

Comparison of Mitoxantrone versus Cyclophosphamide Treatment in Patients with Secondary Progressive Multiple Sclerosis

Öz:

Objective: Mitoxantrone (Mtx) and cyclophosphamide (Cyc) have successfully been used in highly aggressive multiple sclerosis (MS) patients. This study aims to compare the efficacy of these drugs in patients with secondary progressive MS (pwSPMS). Method: Clinical data of pwSPMS treated with either Mtx or Cyc were collected retrospectively. The EDSS scores before, during, and after the drug was determined. The efficacy of the drug was evaluated according to the EDSS change after the completion of therapy. The variations in clinical benefit between the two groups were investigated, as well as the factors that influenced them. Results: Fifty-nine SPMS patients (29 Mtx, 30 Cyc) were included in our study. Mean treatment periods were 19.5±9.9 months for Mtx and 9.1±4.1 months for the Cyc group. Mean EDSS in Mtx and Cyc groups at the first dose were 6.2±0.7 and 6.3±0.8, respectively (p=0.42). The percentage of patients who benefited from treatment was 41.6% in the Mtx group and 43.0% in the Cyc group (p=0.54). However, Mtx was more effective in patients with younger age of disease onset (p=0.01). Conclusion: Immunosuppression with intravenous Mtx and Cyc may equally prevent progression in patients with SPMS. Additionally, Mtx may be more beneficial in MS patients with earlier disease onset.

Anahtar Kelime:

Sekonder Progresif Multipl Skleroz Hastalarında Mitoksantron ve Siklofosfamid Tedavilerinin Etkinliğinin Karşılaştırılması

Öz:

Amaç: Mitoksantron (Mtx) ve siklofosfamid (Cyc)agresif gidişli multipl skleroz hastalarında başarıyla kullanılmıştır. Bu çalışma, sekonder progresif multipl sklerozlu (SPMS) hastalarında bu ilaçların etkinliklerini karşılaştırmayı amaçlamaktadır. Yöntemler: Mtx veya Cyc ile tedavi edilen SPMS hastalarının klinik verileri geriye dönük olarak toplandı. İlaç öncesinde, ilacı kullanırken ve kesildikten sonrasındaki EDSS skorları belirlendi. İlacın etkinliği, tedavi tamamlandıktan sonraki EDSS değişikliğine göre değerlendirildi. İki grup arasındaki klinik faydada farklılıklar ve bunları etkileyen faktörler araştırıldı. Bulgular: Çalışmaya elli dokuz SPMS hastası (29 Mtx, 30 Cyc) dahil edildi. Ortalama tedavi süreleri Mtx için 19.5±9.9 ay ve Cyc grubu için 9.1±4.1 ay idi. İlk doz öncesi ortalama EDSS skorları Mtx grubunda 6.2±0.7 ve Cyc grubunda 6.3±0.8 idi (p=0.42). Tedaviden fayda gören hastaların oranı Mtx grubunda %41.6 ve Cyc grubunda %43.0 idi (p=0.54). Ancak Mtx, MS başlangıç yaşı daha küçük olan hastalarda daha etkiliydi (p=0.01). Sonuç: İntravenöz Mtx ve Cyc ile immünosupresyon, SPMS'li hastalarda progresyonu eşit derecede önleyebilir. Ek olarak, Mtx daha erken hastalık başlangıcı olan MS hastalarında daha faydalı olabilir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	GÜNDÜZ T, Ozcan G, Cakar A, AKCAY h, Ozdag Acarli A, ERAKSOY M, Kürtüncü M (2022). Comparison of Mitoxantrone versus Cyclophosphamide Treatment in Patients with Secondary Progressive Multiple Sclerosis. , 29 - 35. 10.5798/dicletip.1086113
Chicago	GÜNDÜZ TUNCAY,Ozcan Gonca,Cakar Arman,AKCAY halil ibrahim,Ozdag Acarli Ayse Nur,ERAKSOY MEFKURE,Kürtüncü Murat Comparison of Mitoxantrone versus Cyclophosphamide Treatment in Patients with Secondary Progressive Multiple Sclerosis. (2022): 29 - 35. 10.5798/dicletip.1086113
MLA	GÜNDÜZ TUNCAY,Ozcan Gonca,Cakar Arman,AKCAY halil ibrahim,Ozdag Acarli Ayse Nur,ERAKSOY MEFKURE,Kürtüncü Murat Comparison of Mitoxantrone versus Cyclophosphamide Treatment in Patients with Secondary Progressive Multiple Sclerosis. , 2022, ss.29 - 35. 10.5798/dicletip.1086113
AMA	GÜNDÜZ T,Ozcan G,Cakar A,AKCAY h,Ozdag Acarli A,ERAKSOY M,Kürtüncü M Comparison of Mitoxantrone versus Cyclophosphamide Treatment in Patients with Secondary Progressive Multiple Sclerosis. . 2022; 29 - 35. 10.5798/dicletip.1086113
Vancouver	GÜNDÜZ T,Ozcan G,Cakar A,AKCAY h,Ozdag Acarli A,ERAKSOY M,Kürtüncü M Comparison of Mitoxantrone versus Cyclophosphamide Treatment in Patients with Secondary Progressive Multiple Sclerosis. . 2022; 29 - 35. 10.5798/dicletip.1086113
IEEE	GÜNDÜZ T,Ozcan G,Cakar A,AKCAY h,Ozdag Acarli A,ERAKSOY M,Kürtüncü M "Comparison of Mitoxantrone versus Cyclophosphamide Treatment in Patients with Secondary Progressive Multiple Sclerosis." , ss.29 - 35, 2022. 10.5798/dicletip.1086113
ISNAD	GÜNDÜZ, TUNCAY vd. "Comparison of Mitoxantrone versus Cyclophosphamide Treatment in Patients with Secondary Progressive Multiple Sclerosis". (2022), 29-35. https://doi.org/10.5798/dicletip.1086113

APA	GÜNDÜZ T, Ozcan G, Cakar A, AKCAY h, Ozdag Acarli A, ERAKSOY M, Kürtüncü M (2022). Comparison of Mitoxantrone versus Cyclophosphamide Treatment in Patients with Secondary Progressive Multiple Sclerosis. Dicle Tıp Dergisi, 49(1), 29 - 35. 10.5798/dicletip.1086113
Chicago	GÜNDÜZ TUNCAY,Ozcan Gonca,Cakar Arman,AKCAY halil ibrahim,Ozdag Acarli Ayse Nur,ERAKSOY MEFKURE,Kürtüncü Murat Comparison of Mitoxantrone versus Cyclophosphamide Treatment in Patients with Secondary Progressive Multiple Sclerosis. Dicle Tıp Dergisi 49, no.1 (2022): 29 - 35. 10.5798/dicletip.1086113
MLA	GÜNDÜZ TUNCAY,Ozcan Gonca,Cakar Arman,AKCAY halil ibrahim,Ozdag Acarli Ayse Nur,ERAKSOY MEFKURE,Kürtüncü Murat Comparison of Mitoxantrone versus Cyclophosphamide Treatment in Patients with Secondary Progressive Multiple Sclerosis. Dicle Tıp Dergisi, vol.49, no.1, 2022, ss.29 - 35. 10.5798/dicletip.1086113
AMA	GÜNDÜZ T,Ozcan G,Cakar A,AKCAY h,Ozdag Acarli A,ERAKSOY M,Kürtüncü M Comparison of Mitoxantrone versus Cyclophosphamide Treatment in Patients with Secondary Progressive Multiple Sclerosis. Dicle Tıp Dergisi. 2022; 49(1): 29 - 35. 10.5798/dicletip.1086113
Vancouver	GÜNDÜZ T,Ozcan G,Cakar A,AKCAY h,Ozdag Acarli A,ERAKSOY M,Kürtüncü M Comparison of Mitoxantrone versus Cyclophosphamide Treatment in Patients with Secondary Progressive Multiple Sclerosis. Dicle Tıp Dergisi. 2022; 49(1): 29 - 35. 10.5798/dicletip.1086113
IEEE	GÜNDÜZ T,Ozcan G,Cakar A,AKCAY h,Ozdag Acarli A,ERAKSOY M,Kürtüncü M "Comparison of Mitoxantrone versus Cyclophosphamide Treatment in Patients with Secondary Progressive Multiple Sclerosis." Dicle Tıp Dergisi, 49, ss.29 - 35, 2022. 10.5798/dicletip.1086113
ISNAD	GÜNDÜZ, TUNCAY vd. "Comparison of Mitoxantrone versus Cyclophosphamide Treatment in Patients with Secondary Progressive Multiple Sclerosis". Dicle Tıp Dergisi 49/1 (2022), 29-35. https://doi.org/10.5798/dicletip.1086113