Debouverie M, Taillandier L, Pittion-Vouyovitch S, Louis S, Vespignani H
Department of Neurology, Central Hospital, 54000 Nancy, France.
Mult Scler. 2007 Jun;13(5):626-31. doi: 10.1177/1352458506072543. Epub 2007 Feb 9.
The objectives of this study were to assess the benefits of 1) mitoxantrone after three years of follow-up and 2) disease-modifying treatment (DMT) after stopping mitoxantrone. A retrospective analysis was performed on 304 patients with active relapsing-remitting (RR) or progressive multiple sclerosis (PMS) who were treated with mitoxantrone. After mitoxantrone therapy, some patients received DMT (interferon-beta or glatiramer acetate) while others did not. The disease course of the two groups was evaluated by the Expanded Disability Status Scale (EDSS) before and after mitoxantrone and then every year for three years. The mean EDSS score at starting mitoxantrone and three years after stopping mitoxantrone respectively, were: 3.3 (1.3) and 3.2 (1.7) for the RRMS patients and 5.9 (1.2) and 6.4 (1.4) for the PMS patients. Before starting mitoxantrone, demographic and clinical parameters of predictive disability were not significantly different between patients who received DMT or not. The variation of EDSS between time of stopping mitoxantrone and three years later was significantly different (+0.9 versus +0.3; P=0.03) for patients with RRMS. We found that mitoxantrone treatment induces stable disease up to two years after discontinuation of mitoxantrone therapy. In the third year, patients without DMT deteriorated.
1）米托蒽醌在三年随访后的益处；2）停止使用米托蒽醌后疾病修正治疗（DMT）的益处。对304例接受米托蒽醌治疗的复发缓解型（RR）或进展型多发性硬化症（PMS）患者进行了回顾性分析。米托蒽醌治疗后，一些患者接受了DMT（干扰素-β或醋酸格拉替雷），而另一些患者未接受。通过扩展残疾状态量表（EDSS）在米托蒽醌治疗前后以及随后三年每年评估两组的疾病进程。RRMS患者开始使用米托蒽醌时和停止使用米托蒽醌三年后的平均EDSS评分分别为：3.3（1.3）和3.2（1.7），PMS患者为5.9（1.2）和6.4（1.4）。在开始使用米托蒽醌之前，接受或未接受DMT的患者之间预测残疾的人口统计学和临床参数无显著差异。RRMS患者在停止使用米托蒽醌至三年后的EDSS变化有显著差异（+0.9对+0.3；P=0.03）。我们发现，米托蒽醌治疗在停止米托蒽醌治疗后两年内可诱导疾病稳定。在第三年，未接受DMT的患者病情恶化。
