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Efficacy of mitoxantrone and intrathecal triamcinolone acetonide treatment in chronic progressive multiple sclerosis patients.Hellwig K, Schimrigk S, Lukas C, Hoffmann V, Brune N, Przuntek H, Muller T.
Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Gudrunstrasse 56, 44791 Bochum, Germany.

ABSTRACT: Treatment approaches are rare for chronic progressive patients with multiple sclerosis (MS). Objective was to evaluate the clinical benefit of repeated intrathecal application of the sustained release steroid triamcinolone acetonide or the administration of mitoxantrone (MIX) in 2 similar cohorts of chronic progressive patients with MS in an open-label fashion. Expanded Disability Status Scale scores significantly decreased after the first 6 intraspinal triamcinolone acetonide injections, which were performed every third day, and then remained stable. Walking distance significantly increased and did not reduce until the end of the 1-year-long trial period. Mitoxantrone treatment did not improve the Expanded Disability Status Scale score; however, no further significant deterioration appeared. Walking distance did not significantly decrease. Both treatment regimens were safe; the patients experienced nearly no adverse effects. Triamcinolone acetonide application provided a clinical benefit, whereas MIX administration prevented further worsening of MS symptoms. We stress that only specialists with a broad experience in intraspinal triamcinolone acetonide application and MIX administration should perform both kinds of therapy only after a careful information and risk-benefit evaluation in cooperation with the patient. Future trials will show the efficacy of combination of both treatment approaches in chronic progressive patients with MS.

PMID: 16960474 [PubMed - in process]

Thanks Scooby.

Never heard of triamcinolone acetonide before. It's interesting that the researchers are going to examine a combo of mx and triamcinolone acetonide.

It must be good news for those in the progressive stage that a number of treatments / combos of treatments are being examined as current options are very limited. It's also good news that disability reduction rather than just measures of lesion load / inflammation are being used to asess the efficacy of a treatment.

Ian

I totally agree Ian. A lot of different trials are including progressive forms and some seem to show promise. That's quite an improvement since they had no hope on the horizon a few years ago. I had never heard of triamcinolone acetonide either but that illustrates that there are even more things out there that we don't even know about yet that might be effective. I truly believe that within the next 10 years we are going to see real progress for repair and control for all types of this disease and others. It's an exciting time in science. I just wish it would hurry up.

oo

I also didn't find anything that wasn't from 2004 but here's some general info. I wonder if it was just flying under the radar or there's was some other reason we haven't heard much about it.

How does it work?

Triamcinolone acetonide is a type of medicine known as a corticosteroid. Corticosteroids are hormones produced naturally by the adrenal glands which have many important functions on every organ system. Corticosteroids affect the strength of heart muscle and its response to natural chemicals affecting heart rate. They affect the water and salt balance in the body and also enable the body to cope with stress. Stress includes changes in temperature, pain, fear, anxiety and illness and can be hazardous if the body is not equiped to cope, due to low levels of corticosteroids. Corticosteroids allow us to respond to stress by increasing the rate and force of the heartbeat, increasing blood supply to essential tissues (muscle, heart, brain), increasing the body's supply of energy by raising blood sugar and by several other effects on body systems. Triamcinolone acetonide is a synthetic corticosteroid and is given by injection in many situations where a lasting corticosteroid effect is required. This includes replacement therapy in people whose adrenal glands are not producing enough natural steroids (adrenal insufficiency) and decreasing inflammation in certain disease states. Corticosteroids decrease inflammation by acting within cells to prevent the release of certain chemicals that are important in the immune system. These chemicals are normally involved in producing immune and allergic responses, resulting in inflammation. By decreasing the release of these chemicals in a particular area, inflammation is reduced. This can help control a wide number of disease states, characterised by excessive inflammation. They include severe allergic reactions, inflammation of the lungs in asthma and inflammation of the joints in arthritis. The injection can be given as a single dose to people who suffer from hayfever and don't respond to conventional therapy. This can relieve symptoms over the entire hayfever period. Triamcinolone may also be given by injection directly into a joint to relieve inflammation and pain and increase mobility of the affected joint, in conditions such as arthritis. Triamcinolone also decreases the numbers of white blood cells circulating in the blood. This is useful for the treatment of certain types of leukaemia, where there is an abnormally large production of certain white blood cells. It is also used to treat some diseases which are caused by the immune system attacking the body's own tissues (auto immune diseases). Triamcinolone is used in much higher doses than the levels of corticosteroids produced naturally by the body, and as such, the usual actions of corticosteroids become exaggerated and can be observed as side effects of this medicine.