Intense immunosuppression in chronic progressive multiple sclerosis: the Kaiser study

The value of a short course of intensive immunosuppression with cyclophosphamide in stabilising chronic progressive multiple sclerosis (MS) was examined in a randomised single-blinded, placebo-controlled clinical trial. Forty two patients, from the Kaiser Permanente Medical Care Program, Northern Ca...

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Bibliographic Details
Published in:Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 1991-12, Vol.54 (12), p.1055-1060
Main Authors: Likosky, W H, Fireman, B, Elmore, R, Eno, G, Gale, K, Goode, G B, Ikeda, K, Laster, J, Mosher, C, Rozance, J
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Chronic Disease
Cyclophosphamide - therapeutic use
Female
Folic Acid - therapeutic use
Humans
Immunomodulators
Immunosuppression
Male
Medical sciences
Middle Aged
Multiple Sclerosis - drug therapy
Pharmacology. Drug treatments
Single-Blind Method
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Summary:The value of a short course of intensive immunosuppression with cyclophosphamide in stabilising chronic progressive multiple sclerosis (MS) was examined in a randomised single-blinded, placebo-controlled clinical trial. Forty two patients, from the Kaiser Permanente Medical Care Program, Northern California, were studied. Twenty two patients received a short course of cyclophosphamide in an outpatient neurology clinic until their leucocyte counts fell below 4000/mm3, and 20 patients received folic acid. Level of disability, impairment of functional systems, and performance of social roles were assessed before randomisation and reassessed 12, 18, and 24 months after therapy. In both the cyclophosphamide and folic acid groups, the mean level of disability increased from the baseline examination to the 12 month follow up examination (the primary endpoint) by 0.5 on Kurtzke's Expanded Disability Status Scale, indicating similar disease progression in the two groups. Although immunosuppression therapy can be safely administered to MS patients in an outpatient clinic, evidence of substantial benefits was not found.
ISSN:0022-3050
1468-330X
DOI:10.1136/jnnp.54.12.1055