Tratamento imunossupressor na esclerose múltipla

Abstract

An open, retrospective, uncontrolled study was carried out to evaluate efficacy and tolerability of immunosuppressive therapy used in the period 1982-1990 in patients with clinically definite multiple sclerosis. Of 42 patients 43% were treated with one drug, and the others with more than one. Tolerability was evaluated after at least 6 months of therapy in 6 patients on prednisone, 26 on azathioprine, 17 on methyl-prednisolone and 15 on cyclophosphamide pulses. Reversible mild or moderate side-effects were noted in 54% of the patients on azathioprine, leading to change in dose or withdrawal. There were similar side-effects in 83% of the patients on prednisone, 40% of those on cyclophosphamide, and in 12% of those on methylprednisolone. Efficacy was evaluated in 15 patients with a follow-up of at least 2 years, measured by objective scales. The results indicated therapy appeared to arrest progress of disability. We conclude that this study supports the use of immunosuppression in selected cases with rapidly evolving neurological deficits.

Multiple sclerosis: long-term remission after a high dose of cyclophosphamide

“…The use of immune suppression in multiple sclerosis (MS) was described in 1960s, and we introduced the use of azathioprine and cyclophosphamide for neuroimmunological disorders in Brazil in the early 1980s (1,2). In the past few years, an array of so-called Ôdisease-modifyingÕ agents has occupied the front line of therapy, but a significant proportion of cases continue to have relapses.…”