Controlled Pilot Trial of Monthly Intravenous Cyclophosphamide in Multiple Sclerosis

Systematic review of immunomodulatory drugs for the treatment of people with multiple sclerosis: Is there good quality evidence on effectiveness and cost?

“…Another trial (score 1/5)11 suggested that boosters of cyclophosphamide may slow progression, with NNT calculated as 9 (95%CI 5-infinity). The other studies (scores 4/5, 2/5, 2/5)8-10 did not confirm a delay in progression; this was to be expected in one trial8 which only included patients with relapsing-remitting multiple sclerosis.…”

“…Evidence on the effectiveness of azathioprine came from a good quality systematic review4 and two subsequent RCTs: one good quality placebo controlled double blind trial5 and one poor open label RCT 6. Of the five RCTs assessing cyclophosphamide,7-11 only one was a good quality double blind crossover RCT 8. The remaining four were of poor quality, either lacking descriptions of randomisation or details of withdrawals, and none were double blinded.…”

“…The one study of cyclophosphamide scoring 4/58reported on the mean number of relapses in patients with relapsing-remitting disease. The cyclophosphamide group showed a decrease in the mean number of relapses compared with placebo but results did not achieve significance.…”

Systematic review of immunomodulatory drugs for the treatment of people with multiple sclerosis: Is there good quality evidence on effectiveness and cost?

“…Another trial (score 1/5)11 suggested that boosters of cyclophosphamide may slow progression, with NNT calculated as 9 (95%CI 5-infinity). The other studies (scores 4/5, 2/5, 2/5)8-10 did not confirm a delay in progression; this was to be expected in one trial8 which only included patients with relapsing-remitting multiple sclerosis.…”

“…Evidence on the effectiveness of azathioprine came from a good quality systematic review4 and two subsequent RCTs: one good quality placebo controlled double blind trial5 and one poor open label RCT 6. Of the five RCTs assessing cyclophosphamide,7-11 only one was a good quality double blind crossover RCT 8. The remaining four were of poor quality, either lacking descriptions of randomisation or details of withdrawals, and none were double blinded.…”

“…The one study of cyclophosphamide scoring 4/58reported on the mean number of relapses in patients with relapsing-remitting disease. The cyclophosphamide group showed a decrease in the mean number of relapses compared with placebo but results did not achieve significance.…”

Does Cyclophosphamide Play a Protective Role Against Neuronal Loss in Chronic T. cruzi Infection?

“…Multiple sclerosis (MS) treatment, for instance, uses immunosuppressive agents. A clinical experience with CY in MS has confirmed its potent antiinflammatory activity as reflected by its efficacy against relapses [17] and active brain lesions [18]. The response to CY administration is clearly linked to the stage of the disease.…”

EFNS guidelines on diagnosis and management of neuromyelitis optica

“…Cyclophosphamide: Cyclophosphamide, an alkylating chemotherapeutic drug related to nitrogen mustards, is a non‐specific immunosuppressant that affects both T‐cell and B‐cell functions. Immunosuppression is transient when cyclophosphamide is given in standard pulse doses, and the immune system returns to baseline within a few months to a year after cessation [136]. Published treatment regimens for i.v.…”

Systematic review of immunomodulatory drugs for the treatment of people with multiple sclerosis: Is there good quality evidence on effectiveness and cost?

“…Another trial (score 1/5)11 suggested that boosters of cyclophosphamide may slow progression, with NNT calculated as 9 (95%CI 5-infinity). The other studies (scores 4/5, 2/5, 2/5)8-10 did not confirm a delay in progression; this was to be expected in one trial8 which only included patients with relapsing-remitting multiple sclerosis.…”

“…Evidence on the effectiveness of azathioprine came from a good quality systematic review4 and two subsequent RCTs: one good quality placebo controlled double blind trial5 and one poor open label RCT 6. Of the five RCTs assessing cyclophosphamide,7-11 only one was a good quality double blind crossover RCT 8. The remaining four were of poor quality, either lacking descriptions of randomisation or details of withdrawals, and none were double blinded.…”

“…The one study of cyclophosphamide scoring 4/58reported on the mean number of relapses in patients with relapsing-remitting disease. The cyclophosphamide group showed a decrease in the mean number of relapses compared with placebo but results did not achieve significance.…”

Does Cyclophosphamide Play a Protective Role Against Neuronal Loss in Chronic T. cruzi Infection?

“…Multiple sclerosis (MS) treatment, for instance, uses immunosuppressive agents. A clinical experience with CY in MS has confirmed its potent antiinflammatory activity as reflected by its efficacy against relapses [17] and active brain lesions [18]. The response to CY administration is clearly linked to the stage of the disease.…”

EFNS guidelines on diagnosis and management of neuromyelitis optica

“…Cyclophosphamide: Cyclophosphamide, an alkylating chemotherapeutic drug related to nitrogen mustards, is a non‐specific immunosuppressant that affects both T‐cell and B‐cell functions. Immunosuppression is transient when cyclophosphamide is given in standard pulse doses, and the immune system returns to baseline within a few months to a year after cessation [136]. Published treatment regimens for i.v.…”

Systematic review of immunomodulatory drugs for the treatment of people with multiple sclerosis: Is there good quality evidence on effectiveness and cost?

“…Another trial (score 1/5)11 suggested that boosters of cyclophosphamide may slow progression, with NNT calculated as 9 (95%CI 5-infinity). The other studies (scores 4/5, 2/5, 2/5)8-10 did not confirm a delay in progression; this was to be expected in one trial8 which only included patients with relapsing-remitting multiple sclerosis.…”

“…Evidence on the effectiveness of azathioprine came from a good quality systematic review4 and two subsequent RCTs: one good quality placebo controlled double blind trial5 and one poor open label RCT 6. Of the five RCTs assessing cyclophosphamide,7-11 only one was a good quality double blind crossover RCT 8. The remaining four were of poor quality, either lacking descriptions of randomisation or details of withdrawals, and none were double blinded.…”

“…The one study of cyclophosphamide scoring 4/58reported on the mean number of relapses in patients with relapsing-remitting disease. The cyclophosphamide group showed a decrease in the mean number of relapses compared with placebo but results did not achieve significance.…”

Does Cyclophosphamide Play a Protective Role Against Neuronal Loss in Chronic T. cruzi Infection?

“…Multiple sclerosis (MS) treatment, for instance, uses immunosuppressive agents. A clinical experience with CY in MS has confirmed its potent antiinflammatory activity as reflected by its efficacy against relapses [17] and active brain lesions [18]. The response to CY administration is clearly linked to the stage of the disease.…”

EFNS guidelines on diagnosis and management of neuromyelitis optica

“…Cyclophosphamide: Cyclophosphamide, an alkylating chemotherapeutic drug related to nitrogen mustards, is a non‐specific immunosuppressant that affects both T‐cell and B‐cell functions. Immunosuppression is transient when cyclophosphamide is given in standard pulse doses, and the immune system returns to baseline within a few months to a year after cessation [136]. Published treatment regimens for i.v.…”