cqvip:Cyclophosphamide (CTX) is an alkylating agent related to nitrogen mustards whose anti- inflammatory and immunosuppressive effects have been utilised to treat selected cases of multiple sclerosis with a progressive and worsening course. To halt the progression of disease in patients refractory to disease modifying drugs CTX has been given, and several open- label studies have recently shown clinical benefits. In a previous study we demonstrated the effectiveness of a combination of IV monthly pulses of CTX and interferon β .(IFN- β )in10 patients with “ rapidly transitional" form of multiple sclerosis characterised by severe and frequent attacks and rapid progression of disability. The present study reports the clinical and MRI follow- up 36 months after the discontinuation of CTX showing the maintenance of the results obtained in relapse rate (p < 0.001), EDSS (p < 0.001), T2 MRI total lesion load (p < 0.001) and T2 lesions number (p < 0.001) compared to the pre- treatment period. These encouraging findings and the absence of significant recorded side effects affirm that the association of CTX plus interferon- beta is amenable, safe and can be recommended in rapidly worsening MS patients.
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