تغييرات اندكس كسر جهشي ناشي از عوارض قلبي داروي ميتوكسانترون در درمان بيماران با نوع ثانويه پيش رونده مولتيپل اسكلروزيس

Evaluation of ejection fraction changes during the course of treatment of mitoxantrone in patients with secondary progressive form of multiple sclerosis

Multiple sclerosis (MS) is one of the most common neurological disorders in young adults.Mitoxantrone, as an immunosuppressant and cytotoxic drug has shown a slight beneficial effect on the progressive form of the disease. However, it has been experienced that in cancer treatment this drug has caused cardiologic side effects such as congestive heart failure and decrease in ejection fraction. The aim of this study is to investigate the left ventricular ejection fraction changes induced by Mitoxantrone as administered in patients with secondary progressive form of multiple sclerosis.During the years of 2005-2007, the patients with secondary progressive MS who referred to the Neurological Clinic of Aria General Hospital in Mashhad were included in our cross-sectional study. These patients had no history of hematological, cardiac or hepatic disorders. Neither they had ever used immunosuppressant drugs. They were prescribed to intravenously take 12 mg/m2 of Mitoxantrone every 3 months for at least 2 years. Before each infusion of Mitxantrone, the left ventricular ejection fraction (EF) was measured by echocardiography. After the treatment (8 infusions), the results of echocardiography were compared and analyzed through statistical methods using SPSS and Excel soft wares.Forty four patients with secondary progressive -MS were included in our study (24 females and 20 males). Five of the subjects were younger than 30 year old, 27 patients were between 30 and 40, and 12 patients were above 40. The data was analyzed using the method of repeated measures. The results demonstrate that Mitoxantrone had no significant effect on the left ventricular ejection fraction. Also, the trend mean of EF during 8 months showed no significant drop. The mean of EF between sexes was not significant, either. As a whole, ten percent of the subjects treated with Mitoxanterone showed a decrease of EF which returned to its normal stage once the treatment was stopped.The benefit from using Mitoxanterone in multiple sclerosis was more than the complication caused by its usage.