Mitoxantrone reduced disability in Iranian patients with multiple sclerosis.

BACKGROUND Multiple sclerosis is a leading cause of disability in young adults. Mitoxantrone has recently been shown to be effective in ameliorating multiple sclerosis activity and reducing the relapse rate. This study aimed to assess the efficacy of mitoxantrone on disease activity and decreasing relapse rate in patients with multiple sclerosis in Iran. METHODS This was a clinical trial on patients who received intravenous mitoxantrone, 12 mg/m2 every 3 months. The study was performed at Isfahan Multiple Sclerosis Clinics, affiliated to Isfahan University of Medical Sciences. This clinical trial was conducted from October 2003 through April 2005. One hundred and forty-seven patients with worsening relapsing-remitting and secondary progressive multiple sclerosis received mitoxantrone, 12 mg/m(2) every 3 months. Clinical assessment was made every 3 months for one year. RESULTS Of the 147 patients, 129 (93 females and 36 males) could successfully complete the course of our study. A significant therapeutic effect (P < 0.0001) was detected for the attack rate before and after treatment. The Mean attack rate 12 months before treatment was 1.10 (SD = 0.95), which reduced to 0.09 (SD = 0.29) during treatment. The Mean expanded disability status scale at the beginning of the treatment was 4.32, which declined to 3.62 (P < 0.0001) after one year. CONCLUSION Mitoxantrone was generally well tolerated and reduced progression of disability and clinical exacerbation in our patients. Physicians must be careful about the complications of mitoxantrone especially cardiotoxicity.