Abstract
The chemotherapy agents like azathioprine and mitoxantrone (MITOX) are utilized in a routinely way in patients with multiple sclerosis. The azathioprine is used in the long-term treatment of myasthenia gravis (MG). The mitoxantrone is utilized for the management of the multiple sclerosis and the rituximab, a chimerical antibody monoclonal that exhausts the B cells, has been utilized in some autoimmune neurological diseases and its efficacy is now examining in various clinical trials. This review describes the benefits and secondary effects of the azathioprine, MITOX and rituximab.
The azathioprine reduces the rate of relapses in the multiple sclerosis (EM) even in 21 percent, with a NNT of 7 to10 treatments to preventing a relapse in the first year; the rate of relapses in two years also diminishes. As the azathioprine has less secondary effects that the steroids, has been recommended like a “sparring steroids” in long-term management of the MG. Its adverse effects seem to be less prominent in the MG that in the EM because is utilized frequently in combination with steroids. The most common adverse effects are gastrointestinal and hematological (mielosupresion). An adverse but serious and rare effect is the major long-term risk of malignancy.
The mitoxantrone was approved for the management of the progressive secondary multiple sclerosis, and in the crisis of relapses and remissions form. Various studies suggest that short-term modifies the course in the magnetic resonance image and that stabilizes the neuromielitis optica. The most common secondary effects are alopecia and nausea. A serious adverse effect is cardiac toxicity that can result in heart faillure. Rituximab has been used in the treatment of Ig M autoantibodies neuropathy; in progressive secondary multiple sclerosis and in patients with relapse mielitis. Also it has been utilized in the treatment of paraneoplastic neurological syndromes, and in MG. The security profile of rituximab requires additional studies.
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