Multiple sclerosis symptomatic therapy

Myocardial toxicity, manifested in its most severe form by potentially fatal CHF, may occur either during therapy with mitoxantrone or months to years after termination of therapy. Mitoxantrone use has been associated with cardiotoxicity this risk increases with cumulative dose. In cancer patients, the risk of symptomatic CHF was estimated to be 2.6% for patients receiving up to a cumulative dose of 140 mg/m. For this reason, monitor patients for evidence of cardiac toxicity and question them about symptoms of heart failure prior to initiation of treatment. Monitor patients with multiple sclerosis (MS) who reach a cumulative dose of 100 mg/m for evidence of cardiac toxicity prior to each subsequent dose. Ordinarily, patients with MS should not receive a cumulative dose greater than 140 mg/m. Active or dormant cardiovascular disease, prior or concomitant radiotherapy to the mediastinal/pericardial area, previous therapy with other anthracyclines or anthracenediones, or concomitant use of other cardiotoxic drugs may increase the risk of cardiac toxicity. Cardiac toxicity with mitoxantrone may occur at lower cumulative doses whether or not cardiac risk factors are present (see Warnings and Administration.and.Dosage). 

E Role in therapy Betaseron is useful for reducing symptomatic exacerbation in multiple sclerosis (MS) patients with relapsing-remitting disease. The drug should be considered in patients with ch-nically deflnite or laboratory-supported definite disease. It is not indicated in those patients with primary progressive MS. Interferon beta-la (Avonex) has also demonstrated activity in MS patients. 

An individual case of a 45-year-old female with multiple sclerosis who presented to the emergency department with symptomatic sinus bradycardia after the completion of a high-dose oral prednisone therapy for multiple sclerosis-related optic neuritis has been reported [6 ]. She received l,250mg of oral prednisone per day for 5days in total and finished her course 3 days before her emergency department presentation. The patient s pulse rate and symptoms resolved on their own a week after the completion of the high-dose prednisone. There are very few adult cases that report this side effect and all of them have been with intravenous methylprednisolone. This is the first case report of a patient with symptomatic bradycardia from an oral CS regimen. 

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