Equipping People To Make Sense Of What They Are Told
Cyclophosphamide - Endoxana is a potent immunosuppressive drug that is frequently
used in combination chemotherapy regimens to treat leukaemia and other forms of cancer.Although
not a first line treatment, cyclophosphamide has been used in people with MS who
have failed to respond to other therapies and are experiencing frequent relapses
with rapid progression.
The NICE Guideline states that this treatment should not be used in MS as research
evidence does not show any beneficial effect on the course of the condition.
Revimmune is the brand name of a new application of cyclophosphamide as an ultra-high
intensity, short-course intravenous infusion.
The drug works by eliminating the cells responsible for the immune attack that is
seen in MS, thereby allowing the body's immune system to 'reboot'. It is in development
for a variety of autoimmune diseases, and preliminary findings suggest it holds potential
as a treatment option for people with severe refractory MS - MS that is not responding
to other treatments. However, further studies are necessary to determine the most
appropriate patients for this treatment.
La Mantia L, et al. Cyclophosphamide for multiple sclerosis. Cochrane database of
systematic reviews 2007;(1):CD002819. PubMed
Schwartzman RJ, et al. High-dose cyclophosphamide in the treatment of multiple sclerosis.CNS
Neuroscience & Therapeutics 2009;15(2):118-127. PubMed
Gladstone DE, et al. High-dose cyclophosphamide for moderate to severe refractory
multiple sclerosis. Archives of Neurology 2006;63(10):1388-1393. PubMed
Krishnan C, et al. Reduction of disease activity and disability with high-dose cyclophosphamide
in patients with aggressive multiple sclerosis. Archives of Neurology 2008;65(8):1044-1051.
PubMed
Side effects may occur such as:
Hair loss.
Nausea.
Serious Side effects may occur such as:
Suppression of the bone marrow.
Infertility.
Damage to the foetus in woman who become pregnant whilst on the medication.
Chemical irritation of the bladder - hemorrhagic cystitis.
