MS Answers

Answered on: 10/3/2006

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Q :

I have secondary progressive MS and am progressing rapidly. My M.S. doctor will not prescribe Novantrone as he feels it is too dangerous. If so, why has it been approved and quite generally used? And why do I have to hunt for someone who will help me? This disease is difficult enough without having to jump through these kinds of hurdles.

A :

Mitoxantrone (Novantrone) is approved for “advancing MS” either late relapsing-remitting not fully controlled by standard disease modifying drugs (DMD) such as interferon beta or glatiramer acetate, or for rapidly progressive MS. MS often evolves from an early phase dominated by inflammation to a later stage of degeneration, wherein the nervous system slowly loses neurons and axons (cells and wires); thought to be a direct result of all the accumulated inflammation that has gone unchecked. Mitoxantrone is directed against the very early active inflammation; it does little to nothing for the pure degenerative phase of the illness. Because of its potential toxicity therefore, one need be assured that active inflammation is continuing before recommending Mitoxantrone therapy. Recent relapses, early progression or MRI scanning showing active (enhancing or growing) lesions are usually good indicators of active inflammation. Lack of evidence for this type of inflammation or a history of slow and steady progression usually means that the MS is well into its degenerative phase. If this describes your situation, then it’s clear why your MS doctor is reluctant to prescribe Mitoxantrone, since it will offer little in the way of treatment for this phase of disease; i.e. with no clear ‘benefit’ to outweigh the potential risks or downsides of the agent, your MS doctor is offering you sound advice.

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DISCLAIMER: Please be aware that this information does not necessarily represent the opinion of the MS Society of Canada, and is not intended as medical advice. For specific advice and opinion, always consult a physician.