http://link.springer.de/link/service/journals/10072/bibs/1022002/10220209.htm
Neurological Sciences
Abstract Volume 22 Issue 2 (2001)
pp 209-210
A. Lugaresi, C. Caporale, D. Farina,
F. Marzoli, L. Bonanni, P. A. Muraro, G. De Luca, C. Iarlori, D. Gambi
Neuroimmunology Unit, Department
of Oncology and Neuroscience, Gabriele d'Annunzio University, Via dei Vestini,
I-66013 Chieti, Italy
Abstract.
We aimed to further assess the safety
and efficacy of low-dose oral methotrexate (LDOM) treatment for chronic
progressive MS (CPMS).
We studied 20 CPMS patients, including
16 with secondary progressive MS who had shown disease progression in the
previous year. The mean follow-up was 23 months.
The mean EDSS score was 6.3 ±
1.1 before treatment and 6.4 ± 1.1 after one year of treatment.
At one year, 15 of 20 patients were
still being treated, and 10 were stable.
Twelve patients have completed 18
months of treatment, and eight are stable.
Two patients stopped treatment because
of side effects, two more because they did not perceive benefit, and one
was lost to follow-up.
Six patients had mild, transient
increases in liver enzymes not requiring treatment interruption, and two
had localized herpes zoster.
Magnetic resonance imaging (MRI)
performed before treatment and at one year remained unchanged in responders.
We confirm that LDOM is safe in carefully
selected and monitored CPMS patients.
MTX is inexpensive and, given its
anti-inflammatory and immunomodulatory properties, may be used as add-on
therapy in non-responders to interferon beta, although hepatic toxicity
may be a problem in long-term treatment.
© Springer-Verlag Italia 2001